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Prevalence and prognostic impact of diabetes in takotsubo syndrome: insights from the international, multicenter GEIST registry

OBJECTIVE: In view of low prevalence rates, diabetes is discussed as a protective factor for the occurrence of Takotsubo syndrome (TTS). Furthermore, it was associated with improved outcome in a small single-center analysis. Therefore, this study assessed the prevalence and prognostic relevance of c...

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Main Authors: Stiermaier, Thomas (Author) , Santoro, Francesco (Author) , El-Battrawy, Ibrahim (Author) , Möller, Christian (Author) , Graf, Tobias (Author) , Novo, Giuseppina (Author) , Santangelo, Andrea (Author) , Mariano, Enrica (Author) , Romeo, Francesco (Author) , Caldarola, Pasquale (Author) , Fanelli, Mario (Author) , Thiele, Holger (Author) , Brunetti, Natale Daniele (Author) , Akın, Ibrahim (Author) , Eitel, Ingo (Author)
Format: Article (Journal)
Language:English
Published: 2018
In: Diabetes care
Year: 2018, Volume: 41, Issue: 5, Pages: 1084-1088
ISSN:1935-5548
DOI:10.2337/dc17-2609
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.2337/dc17-2609
Verlag, lizenzpflichtig, Volltext: https://care.diabetesjournals.org/content/41/5/1084.long
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Author Notes:Thomas Stiermaier, Francesco Santoro, Ibrahim El-Battrawy, Christian Möller, Tobias Graf, Giuseppina Novo, Andrea Santangelo, Enrica Mariano, Francesco Romeo, Pasquale Caldarola, Mario Fanelli, Holger Thiele, Natale Daniele Brunetti, Ibrahim Akin and Ingo Eitel
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Summary:OBJECTIVE: In view of low prevalence rates, diabetes is discussed as a protective factor for the occurrence of Takotsubo syndrome (TTS). Furthermore, it was associated with improved outcome in a small single-center analysis. Therefore, this study assessed the prevalence and prognostic relevance of concomitant diabetes in TTS. - RESEARCH DESIGN AND METHODS: A total of 826 patients with TTS were enrolled in an international, multicenter, registry-based study (eight centers in Italy and Germany). All-cause mortality was compared between patients with diabetes and patients without diabetes, and the independent predictive value of diabetes was evaluated in multivariate regression analysis. - RESULTS: The prevalence of diabetes was 21.1% (n = 174). TTS patients with diabetes were older (P < 0.001), were more frequently male (P = 0.003), had a higher prevalence of hypertension (P < 0.001), physical triggers (P = 0.041), and typical apical ballooning (P = 0.010), had a lower left ventricular ejection fraction (P = 0.008), had a higher rate of pulmonary edema (P = 0.032), and had a longer hospital stay (P = 0.009). However, 28-day all-cause mortality did not differ between patients with diabetes and patients without diabetes (6.4% vs. 5.7%; hazard ratio [HR] 1.11 [95% CI 0.55-2.25]; P = 0.772). Longer-term follow-up after a median of 2.5 years revealed a significantly higher mortality among TTS patients with diabetes (31.4% vs. 16.5%; P < 0.001), and multivariate regression analysis identified diabetes as an independent predictor of adverse outcome (HR 1.66 [95% CI 1.16-2.39]; P = 0.006). - CONCLUSIONS: Diabetes is not uncommon in patients with TTS, is associated with increased longer-term mortality rates, and is an independent predictor of adverse outcome irrespective of additional risk factors.
Item Description:Gesehen am 21.04.2020
Physical Description:Online Resource
ISSN:1935-5548
DOI:10.2337/dc17-2609

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