Cardiovascular and Thoracic Department, Careggi University Hospital, Florence, Italy
Clinical and Interventional Cardiology, Sassari University Hospital, Sassari, Italy.
J Am Heart Assoc. 2017 Sep 14;6(9):e006065. doi: 10.1161/JAHA.117.006065.
The CHADS-VASc score predicts stroke in patients with atrial fibrillation and has been reported to have a prognostic role even in acute coronary syndrome patients. The Takotsubo syndrome is a condition that mimics acute coronary syndrome and may present several complications including stroke. We sought to assess the ability of CHADS-VASc score to predict adverse events in Takotsubo syndrome patients.
Overall, 371 Takotsubo syndrome patients were enrolled in a prospective registry. Patients were divided into 3 groups according to the CHADS-VASc score: Group A (≤1), B (2-3), and C (≥4). The median CHADS-VASc score was 3 (interquartile range: 2-4). Overall, 9%, 42%, and 49% were included in Group A, B, and C, respectively. Follow-up length was 26±20 months. The mortality rate was 6%, 7%, and 17% in Group A, B, and C, respectively (=0.011). The stroke rate was 3% and not different among the 3 groups. Estimated major adverse cardiac and cerebrovascular events (the composite of death, myocardial infarction, and stroke) rates in the 3 groups were 6%, 9%, and 17% in Group A, B, and C, respectively (=0.033). The CHADS-VASc score resulted as a predictor of major adverse cardiac and cerebrovascular events (odds ratio 2.1, 95% confidence interval, 1.2-3.6; =0.01) and all-cause mortality (odds ratio 1.5, 95% confidence interval, 1.2-1.9; =0.001).
In Takotsubo syndrome, the CHADS-VASc score allows prediction of cardiovascular events and mortality at long-term follow-up.
CHADS-VASc 评分可预测房颤患者的中风风险，并且在急性冠状动脉综合征患者中也具有预后作用。Takotsubo 综合征是一种类似于急性冠状动脉综合征的疾病，可能会出现多种并发症，包括中风。我们旨在评估 CHADS-VASc 评分预测 Takotsubo 综合征患者不良事件的能力。
总体而言，371 例 Takotsubo 综合征患者被纳入前瞻性登记研究。根据 CHADS-VASc 评分，患者被分为 3 组：A 组（≤1）、B 组（2-3）和 C 组（≥4）。CHADS-VASc 评分中位数为 3（四分位距：2-4）。总体而言，A、B 和 C 组分别有 9%、42%和 49%的患者。随访时间为 26±20 个月。A、B 和 C 组的死亡率分别为 6%、7%和 17%（=0.011）。3 组的卒中发生率无差异。A、B 和 C 组的主要不良心脑血管事件（死亡、心肌梗死和卒中的复合终点）发生率分别为 6%、9%和 17%（=0.033）。CHADS-VASc 评分是主要不良心脑血管事件（比值比 2.1，95%置信区间，1.2-3.6；=0.01）和全因死亡率（比值比 1.5，95%置信区间，1.2-1.9；=0.001）的预测因子。
在 Takotsubo 综合征中，CHADS-VASc 评分可预测长期随访的心血管事件和死亡率。
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