Age-Related Variations in Takotsubo Syndrome.
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Cammann Victoria L, Szawan Konrad A, Stähli Barbara E, Kato Ken, Budnik Monika, Wischnewsky Manfred, Dreiding Sara, Levinson Rena A, Di Vece Davide, Gili Sebastiano, Citro Rodolfo, Bossone Eduardo, Neuhaus Michael, Franke Jennifer, Meder Benjamin, Jaguszewski Miłosz, Noutsias Michel, Knorr Maike, Heiner Susanne, D'Ascenzo Fabrizio, Dichtl Wolfgang, Burgdorf Christof, Kherad Behrouz, Tschöpe Carsten, Sarcon Annahita, Shinbane Jerold, Rajan Lawrence, Michels Guido, Pfister Roman, Cuneo Alessandro, Jacobshagen Claudius, Karakas Mahir, Koenig Wolfgang, Pott Alexander, Meyer Philippe, Roffi Marco, Banning Adrian, Wolfrum Mathias, Cuculi Florim, Kobza Richard, Fischer Thomas A, Vasankari Tuija, Airaksinen K E Juhani, Napp L Christian, Dworakowski Rafal, MacCarthy Philip, Kaiser Christoph, Osswald Stefan, Galiuto Leonarda, Chan Christina, Bridgman Paul, Beug Daniel, Delmas Clément, Lairez Olivier, Gilyarova Ekaterina, Shilova Alexandra, Gilyarov Mikhail, El-Battrawy Ibrahim, Akin Ibrahim, Poledniková Karolina, Toušek Petr, Winchester David E, Galuszka Jan, Ukena Christian, Poglajen Gregor, Carrilho-Ferreira Pedro, Hauck Christian, Paolini Carla, Bilato Claudio, Kobayashi Yoshio, Shoji Toshihiro, Ishibashi Iwao, Takahara Masayuki, Himi Toshiharu, Din Jehangir, Al-Shammari Ali, Prasad Abhiram, Rihal Charanjit S, Liu Kan, Schulze P Christian, Bianco Matteo, Jörg Lucas, Rickli Hans, Pestana Gonçalo, Nguyen Thanh H, Böhm Michael, Maier Lars S, Pinto Fausto J, Widimský Petr, Felix Stephan B, Braun-Dullaeus Ruediger C, Rottbauer Wolfgang, Hasenfuß Gerd, Pieske Burkert M, Schunkert Heribert, Borggrefe Martin, Thiele Holger, Bauersachs Johann, Katus Hugo A, Horowitz John D, Di Mario Carlo, Münzel Thomas, Crea Filippo, Bax Jeroen J, Lüscher Thomas F, Ruschitzka Frank, Ghadri Jelena R, Opolski Grzegorz, Templin Christian
Аннотация
OBJECTIVES: This study aimed to investigate age-related differences in TTS.
METHODS: Patients diagnosed with TTS and enrolled in the International Takotsubo Registry between January 2011 and February 2017 were included in this analysis and were stratified by age (younger: ≤50 years, middle-age: 51 to 74 years, elderly: ≥75 years). Baseline characteristics, hospital course, as well as short- and long-term mortality were compared among groups.
RESULTS: Of 2,098 TTS patients, 242 (11.5%) patients were ≤50 years of age, 1,194 (56.9%) were 51 to 74 years of age, and 662 (31.6%) were ≥75 years of age. Younger patients were more often men (12.4% vs. 10.9% vs. 6.3%; p = 0.002) and had an increased prevalence of acute neurological (16.3% vs. 8.4% vs. 8.8%; p = 0.001) or psychiatric disorders (14.1% vs. 10.3% vs. 5.6%; p < 0.001) compared with middle-aged and elderly TTS patients. Furthermore, younger patients had more often cardiogenic shock (15.3% vs. 9.1% vs. 8.1%; p = 0.004) and had a numerically higher in-hospital mortality (6.6% vs. 3.6% vs. 5.1%; p = 0.07). At multivariable analysis, younger (odds ratio: 1.60; 95% confidence interval: 0.86 to 3.01; p = 0.14) and older age (odds ratio: 1.09; 95% confidence interval: 0.66 to 1.80; p = 0.75) were not independently associated with in-hospital mortality using the middle-aged group as a reference. There were no differences in 60-day mortality rates among groups.
CONCLUSIONS: A substantial proportion of TTS patients are younger than 50 years of age. TTS is associated with severe complications requiring intensive care, particularly in younger patients.