| Abstract: |
The role of age in the short-and long-term prognosis of takotsubo syndrome (TTS) is controversial. The aim of the present study was to evaluate age-related differences and prognostic implications among patients with TTS. In total, 2492 consecutive patients with TTS enrolled in an international registry were stratified into 4 groups (<45, 45-64, 65-74, and ≥75 years). The median long-term follow-up was 480 days (interquartile range, 83-1510 days). The primary outcome was all-cause mortality (in-hospital and out-of-hospital mortality). The secondary end point was TTS-related in-hospital complications. Among the 2479 patients, 58 (2. 3%) were aged <45 years, 625 (25. 1%) were aged 45 to 64 years, 733 (29. 4%) were aged 65 to 74 years, and 1063 (42. 6%) were aged ≥75 years. Young patients (<45 years) had a higher prevalence of men (from youngest to oldest, 24. 1% versus 12. 6% versus 9. 7% versus 11. 4%; P<0. 01), physical trig-gers (46. 6% versus 27. 5%, 33. 9%, and 38. 4%; P<0. 01), and non-apical forms of TTS (25. 9% versus 23. 7%, 12. 7%, and 9%; P<0. 01) than those aged 45 to 64, 65 to 74, and ≥75 years. During hospitalization, young patients experienced a higher rate of in-hospital complications (32. 8% versus 23. 4%, 27. 4%, and 31. 9%; P=0. 01), but in-hospital mortality was higher in the older group (0%, 1. 6%, 2. 9%, and 5%; P=0. 001). Long-term all-cause mortality was significantly higher in the older cohort (5. 6%, 6. 4%, 11. 3%, and 22. 3%; log-rank P<0. 001), as was long-term cardiovascular mortality (0%, 0. 9%, 1. 9%, and 3. 2%; log-rank P=0. 01). Young patients with TTS have a typical phenotype characterized by a higher prevalence of male sex, non-apical ballooning patterns, and in-hospital complications. However, in-hospital and long-term mortality are significantly lower in young patients with TTS. |
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(Ruhr University of Bochum)
