1 1st Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.
2 Department of Noninvasive Cardiology and Hypertension, Central Clinical Hospital of the Ministry of the Interior and Administration, Warsaw, Poland.
J Womens Health (Larchmt). 2018 Dec;27(12):1513-1518. doi: 10.1089/jwh.2017.6754. Epub 2018 Jul 6.
Takotsubo syndrome (TTS) is a clinical condition that mimics acute myocardial infarction (MI). More than 90% patients are women, mainly postmenopausal. Research suggests that up to 5% of women evaluated for a MI actually have TTS and that diagnose may be underestimated. Patients with TTS are generally able to fully recover within a period of days to weeks. However, serious, potentially fatal, complications may occur.
In 117 consecutive female patients hospitalized with TTS and 117 consecutive female patients with ST-segment elevation MI, we collected data regarding cardiovascular risk factors, comorbidities, and complications. We compared all in-hospital complications in both groups and analyzed factors influencing the composite endpoint which was cardiogenic shock and death from any cause.
In our study patients with TTS had a lower incidence of serious complications compared to the ST-segment elevation MI group. Moreover, in-hospital mortality was also lower in the TTS group. The factors which influenced cardiogenic shock and death from any cause were: heart rate at admission, diastolic blood pressure at admission, C-reactive protein (CRP) concentration at admission, chest pain at admission, ST-segment depression in the electrocardiography at admission, and ejection fraction at admission. Moreover, patients with exacerbation of chronic disease as the cause of TTS also reached the composite endpoint more often.
Female patients with TTS had more favorable in-hospital prognoses than patients with ST-segment elevation MI. However, serious complications occurred. The factors which influenced the composite endpoint came from readily available data-within the first hour after admission to the hospital.
心尖球囊样综合征（TTS）是一种类似于急性心肌梗死（MI）的临床病症。超过 90%的患者为女性，主要为绝经后女性。研究表明，在评估为 MI 的女性中，实际上有多达 5%的患者患有 TTS，而这一诊断可能被低估了。TTS 患者通常能够在数天至数周内完全康复。然而，可能会发生严重的、潜在致命的并发症。
在 117 例连续住院的 TTS 女性患者和 117 例连续住院的 ST 段抬高型心肌梗死（STEMI）女性患者中，我们收集了心血管危险因素、合并症和并发症的数据。我们比较了两组患者的所有院内并发症，并分析了影响复合终点（心源性休克和任何原因死亡）的因素。
在我们的研究中，与 STEMI 组相比，TTS 患者的严重并发症发生率较低。此外，TTS 组的院内死亡率也较低。影响心源性休克和任何原因死亡的因素包括：入院时的心率、入院时的舒张压、入院时的 C 反应蛋白（CRP）浓度、入院时的胸痛、入院时心电图的 ST 段压低和射血分数。此外，以慢性疾病恶化作为 TTS 病因的患者也更常达到复合终点。
患有 TTS 的女性患者的院内预后优于 STEMI 患者。然而，严重并发症仍会发生。影响复合终点的因素来自入院后第一个小时内即可获得的常规数据。
