Sistema de Salut de Catalunya
Institut Català de la Salut
[Camblor-Blasco A, Tomasino M] Servei de Cardiologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Nuñez-Gil IJ] Instituto Cardiovascular, Hospital Clínico San Carlos, Universidad Complutense, Madrid, Spain. Universidad Europea, Madrid, Spain. [Duran Cambra A] Cardiology Department, Hospital de Sant Pau, Barcelona, Spain. [Almendro-Delia M] Cardiology Department, Hospital Universitario Virgen Macarena, Sevilla, Spain. [Ródenas-Alesina E] Servei de Cardiologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. CIBERCV, Madrid, Spain. [Fernández-Cordon C] Cardiology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain. [Uribarri A] Servei de Cardiologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. CIBERCV, Madrid, Spain. Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain
Vall d'Hebron Barcelona Hospital Campus
2024-03-27T08:24:39Z
2024-03-27T08:24:39Z
2024-03-19
Takotsubo syndrome; Cardiogenic shock; Extracorporeal membrane oxygenation
Síndrome de Takotsubo; Shock cardiogènic; Oxigenació per membrana extracorpòria
Síndrome de Takotsubo; Shock cardiogénico; Oxigenación por membrana extracorpórea
Background 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. Methods and Results 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. Conclusions 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.
The Registry of Takotsubo Syndrome webpage was funded by a nonconditional AstraZeneca scholarship.
Article
Published version
English
Miocardi - Malalties; Angiografia; Xoc cardiogènic; Mortalitat; DISEASES::Cardiovascular Diseases::Heart Diseases::Ventricular Dysfunction::Ventricular Dysfunction, Left::Takotsubo Cardiomyopathy; DISEASES::Cardiovascular Diseases::Heart Diseases::Myocardial Ischemia::Myocardial Infarction::Shock, Cardiogenic; ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Investigative Techniques::Epidemiologic Methods::Data Collection::Vital Statistics::Mortality::Hospital Mortality; ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Diagnosis::Prognosis; ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Diagnosis::Diagnostic Techniques and Procedures::Diagnostic Imaging::Radiography::Angiography; ENFERMEDADES::enfermedades cardiovasculares::enfermedades cardíacas::disfunción ventricular::disfunción ventricular izquierda::miocardiopatía de Takotsubo; ENFERMEDADES::enfermedades cardiovasculares::enfermedades cardíacas::isquemia miocárdica::infarto de miocardio::choque cardiogénico; TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::técnicas de investigación::métodos epidemiológicos::recopilación de datos::estadísticas vitales::mortalidad::mortalidad hospitalaria; TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::diagnóstico::pronóstico; TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::diagnóstico::técnicas y procedimientos diagnósticos::diagnóstico por imagen::radiografía::angiografía
Wiley
Journal of the American Heart Association;13(6)
https://doi.org/10.1161/JAHA.123.032951
Attribution-NonCommercial-NoDerivatives 4.0 International
http://creativecommons.org/licenses/by-nc-nd/4.0/
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