Differences Between Takotsubo and the Working Diagnosis of Myocardial Infarction With Nonobstructive Coronary Arteries
López-Pais, Javier (Complejo Hospitalario Universitario de Ourense)
Izquierdo Coronel, Barbara (Hospital Universitario de Getafe (Madrid))
Raposeiras-Roubín, Sergio (Hospital Universitario Álvaro Cunqueiro (Vigo))
Alvarez Rodriguez, Leyre (Hospital Clínico Universitario (Santiago de Compostela, Galícia))
Vedia Cruz, Oscar (Hospital Clínico San Carlos (Madrid))
Almendro-Delia, Manuel (Hospital Universitario Virgen Macarena (Sevilla, Andalusia))
Sionis, Alessandro (Institut d'Investigació Biomèdica Sant Pau)
Martin Garcia, Agustin C. (Hospital Clínico Universitario (Salamanca))
Uribarri, Aitor (Hospital Clínico Universitario de Valladolid)
Blanco, Emilia (Hospital Arnau de Vilanova (Lleida, Catalunya))
Martín de Miguel, Irene (Hospital General Universitario Gregorio Marañón)
Abu-Assi, Emad (Hospital Universitario Álvaro Cunqueiro (Vigo))
Galán Gil, David (Hospital Universitario de Getafe (Madrid))
Sestayo Fernández, Manuela (Hospital Clínico Universitario (Santiago de Compostela, Galícia))
Espinosa Pascual, Maria Jesus (Hospital Universitario de Getafe (Madrid))
Agra-Bermejo, Rosa María (Hospital Clínico Universitario (Santiago de Compostela, Galícia))
López Otero, Diego (Hospital Clínico Universitario (Santiago de Compostela, Galícia))
García Acuña, Jose María (Hospital Clínico Universitario (Santiago de Compostela, Galícia))
Alonso Martín, Joaquín Jesús (Hospital Universitario de Getafe. Servicio de Cardiología)
González Juanatey, José Ramón (Hospital Clínico Universitario (Santiago de Compostela, Galícia))
Perez de Juan Romero, Miguel Ángel (Complexo Hospitalario Universitario de Ourense. Servicio de Cardiología)
Núñez-Gil, Ivan J. (Hospital Clínico San Carlos (Madrid))

Date:	2022
Abstract:	Aim: Whether Takotsubo syndrome (TTS) should be classified within myocardial infarction with non-obstructive coronary arteries (MINOCAs) is still controversial. The aim of this work was to evaluate the main differences between TTS and non-TTS MINOCAs. Methods and Results: A cohort study based on two prospective registries: TTS from the RETAKO registry (N:1,015) and patients with non-TTS MINOCAs from contemporary records of acute myocardial infarction from five 5 national centers (N:1,080). Definitions and management recommended by the ESC were used. Survival analysis was based on the Cox regression analysis; propensity score matching (PS) was created to adjust prognostic variables. Takotsubo syndrome were more often women (85. 9 vs. 51. 9%; p < 0. 001) and older (69. 4 ± 12. 5 vs. 64. 5 ± 14. 1 years; p < 0. 001). Atrial fibrillation (AF) was more frequent in non-TTS MINOCAs (10. 4 vs. 14. 4%; p = 0. 007). Psychiatric disorders were more prevalent in TTS (15. 5 vs. 10. 2%, p < 0. 001). In-hospital mortality and complications were higher in TTS: 3. 4 vs. 1. 8%, (p = 0. 015), and 25. 8 vs. 11. 5%, (p < 0. 001). Global mortality before PS matching was 16. 1% in non-TTS MINOCAs and 8. 1% in TTS. Median follow-up was 32. 4 months; after PS matching, TTS had fewer major adverse cardiovascular events (MACEs): hazard ratio (HR) 0. 59; 95% CI 0. 42-0. 83. There were no differences in global mortality (HR 0. 87; CI: 0. 64-1. 19), but TTS had lower cardiovascular mortality (HR 0. 58; CI: 0. 35-0. 98). Conclusion: Compared to the rest of MINOCAs, TTS presents a different patient profile and a more aggressive acute phase. However, its long-term cardiovascular prognosis is better. These results support that TTS should be considered a separate entity with unique characteristics and prognosis.
Note:	Altres ajuts: Sociedad Española de Cardiología.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Takotsubo ; MINOCA ; Definition ; Prognosis ; Working diagnosis
Published in:	Frontiers in Cardiovascular Medicine, Vol. 9 (March 2022) , p. 742010, ISSN 2297-055X

DOI: 10.3389/fcvm.2022.742010
PMID: 35360039

8 p, 918.1 KB

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