Takotsubo Multicenter Registry (REMUTA) - Clinical Aspects, In-Hospital Outcomes, and Long-Term Mortality.
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Almeida Junior Gustavo Luiz Gouvêa de, Mansur Filho João, Albuquerque Denilson Campos de, Xavier Sergio Salles, Pontes Álvaro, Gouvêa Elias Pimentel, Martins Alexandre Bahia Barreiras, Nunes Nágela S V, Carestiato Lilian Vieira, Petriz João Luiz Fernandes, Santos Armando Márcio Gonçalves, Bandeira Bruno Santana, Abufaiad Bárbara Elaine de Jesus, Pacheco Luciana da Camara, Oliveira Maurício Sales de, Ribeiro Filho Paulo Eduardo Campana, Sampaio Pedro Paulo Nogueres, Duque Gustavo Salgado, Camillis Luiz Felipe, Marques André Casarsa, Lourenço Francisco Carlos, Palazzo José Ricardo, Costa Cláudio Ramos da, Silva Bibiana Almeida da, Zukowski Cleverson Neves, Garcia Romulo Ribeiro, Zonis Fernanda de Carvalho, Paula Suzana Andressa Morais de, Ferrari Carolina Gravano Ferraz, Rangel Bruno Soares da Silva, Ferreira Roberto Muniz, Mendes Bárbara Ferreira da Silva, Castro Isabela Ribeiro Carvalho de, Souza Leonardo Giglio Gonçalves de, Araújo Luiz Henrique Dos Santos, Giani Alexandre
Аннотация
OBJECTIVE: To describe the clinical characteristics, prognosis, in-hospital treatment, in-hospital mortality, and mortality during 1 year of follow-up.
METHODS: This is an observational, retrospective registry study including patients admitted to the hospital with diagnosis of TTS and patients admitted for other reasons who developed this condition. Evaluated outcomes included triggering factor, analysis of exams, use of medications, complications, in-hospital mortality, and mortality during 1 year of follow-up. A significance level of 5% was adopted.
RESULTS: The registry included 169 patients from 12 centers in the state of Rio de Janeiro, Brazil. Mean age was 70.9 ± 14.1 years, and 90.5% of patients were female; 63% of cases were primary TTS, and 37% were secondary. Troponin I was positive in 92.5% of patients, and median BNP was 395 (176.5; 1725). ST-segment elevation was present in 28% of patients. Median left ventricular ejection fraction was 40 (35; 48)%. We observed invasive mechanical ventilation in 25.7% of cases and shock in 17.4%. Mechanical circulatory support was used in 7.7%. In-hospital mortality was 10.6%, and mortality at 1 year of follow-up was 16.5%. Secondary TTS and cardiogenic shock were independent predictors of mortality.
CONCLUSION: The results of the REMUTA show that TTS is not a benign pathology, as was once thought, especially regarding the secondary TTS group, which has a high rate of complications and mortality. (Arq Bras Cardiol. 2020; 115(2):207-216).