Outcomes of takotsubo syndrome at 15 years: A matched cohort study

BACKGROUND: The association of takotsubo syndrome with future risk of cardiovascular and noncardiovascular morbidity and mortality is unclear. We assessed the long-term risk of morbidity and mortality in patients with takotsubo syndrome. METHODS: We performed a matched cohort study of 174 patients with takotsubo syndrome between 1989 and 2006 in Quebec, Canada, with 15 years of follow-up on future hospitalization outcomes. We matched takotsubo patients to two comparison groups, including 1,736 patients with acute myocardial infarction and 1,740 population controls. We estimated hazard ratios (HR) and 95% confidence intervals (CI) for the association of takotsubo syndrome with subsequent in-hospital mortality, cardiovascular morbidity, and other hospitalization outcomes. RESULTS: During 15 years of follow-up, patients with takotsubo syndrome had a similar risk of in-hospital mortality as patients with myocardial infarction (HR 1.06, 95% CI 0.81-1.38), but a lower risk of cardiovascular rehospitalization (HR 0.79, 95% CI 0.66-0.95). Compared with population controls, however, takotsubo was associated with 1.59 times the risk of in-hospital mortality (95% CI 1.21-2.09), 2.71 times the risk of cardiovascular rehospitalization (95% CI 2.24-3.28), and 1.86 times the risk of hospitalization for stress and anxiety disorders (95% CI 1.21-2.85). Associations were significantly stronger the first few years after the initial admission for takotsubo, and weakened over time. CONCLUSIONS: Takotsubo syndrome is associated with a similar risk of mortality as myocardial infarction after 15 years, but a lower risk of cardiovascular rehospitalization. Patients with takotsubo syndrome nonetheless have more in-hospital mortality and cardiovascular morbidity than population controls.
Auteurs (Zotero)
Auger, Nathalie; Paradis, Gilles; Healy-Profitós, Jessica; He, Siyi; Potter, Brian J.
Date de publication (Zotero)
octobre, 2019