Prognostic Utility of Society for Cardiovascular Angiography and Interventions Shock Stage Approach for Classifying Cardiogenic Shock Severity in Takotsubo Syndrome
Camblor-Blasco, Andrea (Hospital Universitari Vall d'Hebron)
Nuñez-Gil, Ivan Javier (Universidad Europea de Madrid)
Duran Cambra, Albert (Institut de Recerca Sant Pau)
Almendro-Delia, Manuel (Hospital Universitario Virgen Macarena (Sevilla, Andalusia))
Ródenas-Alesina, Eduard (Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares)
Fernández-Cordon, Clara (Hospital General Universitario Gregorio Marañón)
Vedia Cruz, Oscar (Universidad Europea de Madrid)
Corbí-Pascual, Miguel (Complejo Hospitalario Universitario de Albacete)
Blanco, Emilia (Hospital Universitario Arnau de Vilanova)
Raposeiras-Roubin, Sergio (Hospital Álvaro Cunqueiro (Vigo))
Guillén Marzo, Marta (Hospital Universitari Joan XXIII de Tarragona)
Sanchez Grande Flecha, Alejandro (Hospital Universitario de Canarias (La Laguna))
Garcia Acuña, Jose Maria (Hospital Clínico Universitario (Santiago de Compostela, Galícia))
Salamanca, Jorge (Hospital Universitario de La Princesa. Instituto de Investigación Sanitaria Princesa (IIS-IP))
Escudier-Villa, Juan M. (Hospital Universitario Puerta de Hierro Majadahonda (Madrid))
Martin-Garcia, Agustin C. (Complejo Asistencial Universitario de Salamanca)
Tomasino, Marco (Hospital Universitari Vall d'Hebron)
Vazirani Ballesteros, Ravi (Universidad Europea de Madrid)
Pérez-Castellanos, Alberto (Hospital Universitari Son Espases (Palma de Mallorca, Balears))
Uribarri, Aitor (Vall d'Hebron Institut de Recerca (VHIR))
Universitat Autònoma de Barcelona

Date:	2024
Abstract:	Cardiogenic shock (CS) is a significant complication of Takotsubo syndrome (TTS), contributing to heightened mortality and morbidity. Despite this, the Society for Cardiovascular Angiography and Interventions (SCAI) staging system for CS severity lacks validation in patients with TTS and CS. This study aimed to characterize a patient cohort with TTS using the SCAI staging system and assess its utility in cases of TTS complicated by CS. From a TTS national registry, 1591 consecutive patients were initially enrolled and stratified into 5 SCAI stages (A through E). Primary outcome was all-cause in-hospital mortality; secondary end points were TTS-related in-hospital complications and 1-year all-cause mortality. After exclusions, the final cohort comprised 1163 patients, mean age 71. 0±11. 8 years, and 87% were female. Patients were categorized across SCAI shock stages as follows: A 72. 1%, B 12. 2%, C 11. 2%, D 2. 7%, and E 1. 8%. Significant variations in baseline demographics, comorbidities, clinical presentations, and in-hospital courses were observed across SCAI shock stages. After multivariable adjustment, each higher SCAI shock stage showed a significant association with increased in-hospital mortality (adjusted odds ratio: 1. 77-29. 31) compared with SCAI shock stage A. Higher SCAI shock stages were also associated with increased 1-year mortality. In a large multicenter patient cohort with TTS, the functional SCAI shock stage classification effectively stratified mortality risk, revealing a continuum of escalating shock severity with higher stages correlating with increased in-hospital mortality. This study highlights the applicability and prognostic value of the SCAI staging system in TTS-related CS.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	SCAI ; Takotsubo syndrome ; Cardiogenic shock ; Extracorporeal membrane oxygenation ; Heart failure
Published in:	Journal of the American Heart Association. Cardiovascular and cerebrovascular disease, Vol. 13 Núm. 6 (2024) , p. e032951, ISSN 2047-9980

DOI: 10.1161/JAHA.123.032951
PMID: 38471832

12 p, 2.2 MB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut de Recerca Sant Pau
Articles > Research articles
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