European journal of clinical investigation · 2025
Age-related differences in cardiogenic shock secondary to Takotsubo syndrome.
СтатьяНазвание и аннотация: Перевод в очереди
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Tomasino Marco, Vazirani Ravi, Salamanca Jorge, Raposeiras-Roubin Sergio, Fernández-Cordón Clara, Corbí-Pascual Miguel, Vedia Oscar, Martín-García Agustín C, Blanco-Ponce Emilia, Almendro Delia Manuel, Piserra-López Alberto, Larre Guerra Jaime Francisco, Gonzalez-Santorum Francisco, Lluch-Requerey Carmen, Guillén-Marzo Marta, Pérez-Castellanos Alberto, Ridocci-Soriano Francisco, Lopez-País Javier, Andrea Rut, Sionis Alessandro, Núñez-Gil Iván J, Uribarri Aitor
Аннотация
BACKGROUND: Age-related differences in Takotsubo Syndrome (TTS) have been described, but there is limited information regarding TTS patients who develop cardiogenic shock (CS).
METHODS AND RESULTS: We analysed data from 408 CS-TTS patients in the RETAKO registry. Patients were stratified into three age groups: ≤50 years (9%), 51-74 years (48%), and ≥75 years (43%). In the youngest group, compared to the middle-aged and the oldest groups, patients were more likely to be male (35% vs. 16% and 14%, p = .01), have a physical trigger (65% vs. 43% and 49%, p = .04), exhibit atypical echocardiographic patterns (27% vs. 11% and 11%, p = .02), and experienced a higher incidence of ventricular arrhythmias (24% vs. 8% and 7%, p = .01). In-hospital mortality rates were 5% in younger patients, 12% in middle-aged patients, and 15% in older patients (p = .15). Older age independently predicted both in-hospital mortality (OR 2.33, 95% CI 1.05-5.17; reference: middle-aged) and 5-year mortality (HR 3.69, 95% CI 1.77-7.67), regardless of shock severity.
CONCLUSIONS: In CS-TTS, younger patients exhibit distinct clinical features but have better outcomes. Older age is associated with higher in-hospital and long-term mortality, regardless of comorbidities and shock severity. These findings underscore the need for age-specific management strategies and further research into the mechanisms underlying age-related differences in CS-TTS.
METHODS AND RESULTS: We analysed data from 408 CS-TTS patients in the RETAKO registry. Patients were stratified into three age groups: ≤50 years (9%), 51-74 years (48%), and ≥75 years (43%). In the youngest group, compared to the middle-aged and the oldest groups, patients were more likely to be male (35% vs. 16% and 14%, p = .01), have a physical trigger (65% vs. 43% and 49%, p = .04), exhibit atypical echocardiographic patterns (27% vs. 11% and 11%, p = .02), and experienced a higher incidence of ventricular arrhythmias (24% vs. 8% and 7%, p = .01). In-hospital mortality rates were 5% in younger patients, 12% in middle-aged patients, and 15% in older patients (p = .15). Older age independently predicted both in-hospital mortality (OR 2.33, 95% CI 1.05-5.17; reference: middle-aged) and 5-year mortality (HR 3.69, 95% CI 1.77-7.67), regardless of shock severity.
CONCLUSIONS: In CS-TTS, younger patients exhibit distinct clinical features but have better outcomes. Older age is associated with higher in-hospital and long-term mortality, regardless of comorbidities and shock severity. These findings underscore the need for age-specific management strategies and further research into the mechanisms underlying age-related differences in CS-TTS.