Impact of concomitant atrial fibrillation on the prognosis of Takotsubo cardiomyopathy

Aims: Previous studies revealed that patients with Takotsubo cardiomyopathy (TTC) have a higher mortality rate than the general population. Supraventricular tachycardia is a well-known complication of TTC. This study was performed to determine the short- and long-term prognostic impact of atrial fib...

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Main Authors: El-Battrawy, Ibrahim (Author) , Lang, Siegfried (Author) , Ansari, Uzair (Author) , Behnes, Michael (Author) , Hillenbrand, Dennis (Author) , Schramm, Katja (Author) , Fastner, Christian (Author) , Zhou, Xiao-Bo (Author) , Bill, Verena (Author) , Hoffmann, Ursula (Author) , Papavassiliu, Theano (Author) , Elmas, Elif (Author) , Haghi, Dariusch (Author) , Borggrefe, Martin (Author) , Akın, Ibrahim (Author)
Format: Article (Journal)
Language:English
Published: 2017
In: Europace
Year: 2016, Volume: 19, Issue: 8, Pages: 1288-1292
ISSN:1532-2092
DOI:10.1093/europace/euw293
Online Access:Verlag, Volltext: http://dx.doi.org/10.1093/europace/euw293
Verlag, Volltext: https://academic.oup.com/europace/article/19/8/1288/2952437
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Author Notes:Ibrahim El-Battrawy, Siegfried Lang, Uzair Ansari, Michael Behnes, Dennis Hillenbrand, Katja Schramm, Christian Fastner, Xiaobo Zhou, Verena Bill, Ursula Hoffmann, Theano Papavassiliu, Elif Elmas, Darius Haghi, Martin Borggrefe, and Ibrahim Akin
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Summary:Aims: Previous studies revealed that patients with Takotsubo cardiomyopathy (TTC) have a higher mortality rate than the general population. Supraventricular tachycardia is a well-known complication of TTC. This study was performed to determine the short- and long-term prognostic impact of atrial fibrillation associated with TTC patients. Methods and results: Our institutional database constituted a collective of 114 patients diagnosed with TTC from 2003 to 2015. The patients were divided into two groups according to the presence (n = 21, 18.4%) or absence (n = 93, 81.5%) of atrial fibrillation. The endpoint was a composite of in-hospital events (thromboembolic events and life-threatening arrhythmias), all-cause mortality, rehospitalization due to heart failure, stroke, and the recurrence of TTC. The in-hospital mortality, 30-day mortality, and long-term mortality were significantly higher in the atrial fibrillation group. Kaplan-Meier analysis indicated a significantly lower event-free survival rate over a mean follow-up of 3 years in the atrial fibrillation group than that in the non-atrial fibrillation group (log-rank, P < 0.01). In a multivariate cox regression analysis, atrial fibrillation (hazard ratio, HR 2.3, 95% confidence interval, CI: 1.1-4.9, P < 0.05) and EF ≤ 35% (HR 2.0, 95% CI: 1.1-3.8, P < 0.05) were the only independent predictors of a primary endpoint. Conclusion: Rates of in-hospital events and short- as well as long-term mortality were significantly higher in TTC patients suffering from atrial fibrillation compared with patients without atrial fibrillation.
Item Description:Gesehen am 03.07.2018
Online publish-ahead-of-print 4 October 2016
Physical Description:Online Resource
ISSN:1532-2092
DOI:10.1093/europace/euw293