Incidence, determinants and prognostic relevance of dyspnea at admission in patients with Takotsubo syndrome: results from the international multicenter GEIST ... View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2020-08-12

AUTHORS

Luca Arcari, Maria Beatrice Musumeci, Thomas Stiermaier, Ibrahim El-Battrawy, Christian Möller, Federico Guerra, Giuseppina Novo, Enrica Mariano, Luca Rosario Limite, Luca Cacciotti, Raffaella Semeraro, Massimo Volpe, Francesco Romeo, Pasquale Caldarola, Holger Thiele, Ibrahim Akin, Natale Daniele Brunetti, Ingo Eitel, Francesco Santoro

ABSTRACT

Clinical presentation of Takotsubo syndrome (TTS) may range from acute chest pain to dyspnea: the prognostic role of clinical onset is still controversial. Aim of this study was therefore to investigate the prognostic relevance of dyspnea at presentation in patients with TTS. We analyzed 1,071 TTS patients (median age 72 years, 90% female) enrolled in the international multicenter GEIST registry. Patients were divided according to the presence or absence of dyspnea at hospital admission, as clinically assessed by the accepting physician. The primary endpoint was occurrence of in-hospital complications defined as a composite of pulmonary edema, cardiogenic shock and death. Overall, 316 (30%) patients presented with dyspnea at hospital admission. Diabetes, lower left ventricular ejection fraction and presence of pulmonary disease or atrial fibrillation were independently associated with dyspnea. In-hospital pulmonary edema, cardiogenic shock and death (17% vs. 3%, p < 0.001; 12% vs. 7%, p = 0.009; 5% vs. 2%, p = 0.004 respectively) and long-term overall mortality (22% vs. 11%, p < 0.001) occurred more frequently in patients with dyspnea than in those without. At multivariable analysis, dyspnea at presentation remained independently associated to both the composite primary endpoint [odds ratio 2.98 (95% confidence interval (CI) 1.95–4.59, p < 0.001] and all-cause mortality [hazard ratio 2.03 (95% CI 1.37–2.99), p < 0.001]. Dyspnea at presentation is common in TTS and is independently associated with in-hospital complications and impaired long-term prognosis. Thorough symptom assessment including dyspnea therefore represents a valuable tool to potentially optimize risk-stratification models for TTS patients. More... »

PAGES

13603

Journal

TITLE

Scientific Reports

ISSUE

1

VOLUME

10

Identifiers

URI

http://scigraph.springernature.com/pub.10.1038/s41598-020-70445-9

DOI

http://dx.doi.org/10.1038/s41598-020-70445-9

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1130042563

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/32788599


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