Weidner K J, El-Battrawy I, Behnes M, Schramm K, Fastner C, Kuschyk J, Hoffmann U, Ansari U, Borggrefe M, Akin I
First Department of Medicine, University Medical Centre Mannheim, Faculty of Medicine Mannheim, University of Heidelberg.
DZHK (German Center for Cardiovascular Research), Partner Site, Heidelberg, Mannheim, Germany.
Ther Clin Risk Manag. 2017 Jul 12;13:863-869. doi: 10.2147/TCRM.S131760. eCollection 2017.
Previous studies revealed that patients with Takotsubo cardiomyopathy (TTC) have a higher mortality rate than the general population. It is still unclear whether sex differences may influence long-term prognosis of TTC patients. The purpose of this study was to determine whether sex differences do influence the short- and long-term outcomes of TTC.
A total of 114 patients with TTC were admitted to the University Medical Centre Mannheim from January 2003 to September 2015 and entered into the TTC database of the University Medical Centre Mannheim, and retrospectively analyzed. Patients were diagnosed by the Mayo Clinic criteria. All-cause mortality over mean follow-up of 1,529±1,121 days was revealed. Significantly more male patients died within long-term follow-up compared to female TTC patients (log-rank test; =0.01). Most males died of noncardiac causes. In multivariate Cox regression analysis, the male sex (=0.02, hazard ratio [HR] 2.8, 95% CI 1.1-7.2), the ejection fraction ≤35% (=0.01, HR 3.3, 95% CI 1.2-9.2) and glomerular filtration rate <60 mL/min (<0.01, HR 3.1, 95% CI 1.4-7.0) figured out as independent predictors of the adverse outcome.
This study shows that males suffering from TTC reveal a higher long-term all-cause mortality rate than females over a 5 year follow-up period.
既往研究表明,应激性心肌病(TTC)患者的死亡率高于普通人群。性别差异是否会影响TTC患者的长期预后仍不清楚。本研究的目的是确定性别差异是否真的会影响TTC的短期和长期预后。
2003年1月至2015年9月期间,共有114例TTC患者入住曼海姆大学医学中心,并纳入曼海姆大学医学中心的TTC数据库,进行回顾性分析。患者根据梅奥诊所标准进行诊断。对平均随访1529±1121天的全因死亡率进行了分析。与女性TTC患者相比,在长期随访中死亡的男性患者明显更多(对数秩检验;P=0.01)。大多数男性死于非心脏原因。在多因素Cox回归分析中,男性(P=0.02,风险比[HR]2.8,95%CI 1.1-7.2)、射血分数≤35%(P=0.01,HR 3.3,95%CI 1.2-9.2)和肾小球滤过率<60 mL/min(P<0.01,HR 3.1,95%CI 1.4-7.0)被确定为不良结局的独立预测因素。
本研究表明,在5年的随访期内,患有TTC的男性的长期全因死亡率高于女性。