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Original research
Outcomes of catecholamine and/or mechanical support in Takotsubo syndrome
  1. Satoshi Terasaki1,
  2. Koshiro Kanaoka2,
  3. Michikazu Nakai2,
  4. Yoko Sumita2,
  5. Kenji Onoue1,
  6. Tsunenari Soeda1,
  7. Makoto Watanabe1,
  8. Yoshihiro Miyamoto3,
  9. Yoshihiko Saito1
  1. 1Department of Cardiovascular Medicine, Nara Medical University, Kashihara, Nara, Japan
  2. 2Department of Medical and Health Information Management, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
  3. 3Open Innovation Center, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
  1. Correspondence to Professor Yoshihiko Saito, Department of Cardiovascular Medicine, Nara Medical University, Kashihara, Nara, Japan; yssaito{at}naramed-u.ac.jp

Abstract

Objective This study aimed to reveal the clinical characteristics of patients with severe Takotsubo syndrome (TTS) who needed catecholamine support (CS) or mechanical support (MS) and to identify factors associated with serious illness and in-hospital mortality.

Methods This was a nationwide retrospective study that used claims data from the Japanese registry of all cardiac and vascular diseases and the diagnosis procedure combination registry, from April 2012 to March 2016. The patients with TTS were divided into severe TTS and mild TTS groups. The severe group was defined as patients who needed CS and/or MS.

Results Among 6169 patients with TTS, 1148 (18.6%) had severe TTS. No significant difference in age was found between the two groups; however, the number of female patients was significantly lower in the severe group than in the mild group. Among 130 patients who underwent MS, 22 and 108 patients required MS alone and both MS and CS, respectively. The 30-day mortality rate was significantly higher in the severe group than in the mild group (11.4% vs 2.6%, p<0.01) and increased with age. Of the patients with severe TTS, 65.6% died within 7 days. Multivariable analysis showed that male sex (OR 1.22, p=0.03), higher Charlson scores (OR 1.11, p<0.01), comorbid pneumonia (OR 1.68, p<0.01), comorbid sepsis (OR 6.02, p<0.01) and ambulance use (OR 2.01, p<0.01) were associated with severe TTS.

Conclusions The rate of severe TTS was 18.6% among 6169 patients registered in the Japanese nationwide database, and the 30-day mortality was higher in patients with severe TTS than in those with mild TTS (11.4% vs 2.6%).

  • cardiomyopathy
  • dilated

Data availability statement

Data may be obtained from a third party and are not publicly available. No additional data available.

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Data availability statement

Data may be obtained from a third party and are not publicly available. No additional data available.

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Footnotes

  • Contributors YSa, KK and ST conceived the study. All authors contributed to the planning of the study. YM, YSu and MN assisted with data collection and material support. All authors contributed to reviewing or revising the manuscript and approved the final version. YSa, KK and ST are responsible for the overall content as guarantors.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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