Tokyo Cardiovascular Care Unit Network Scientific Committee, Tokyo, Japan; Division of Cardiovascular Medicine, Nerima-Hikarigaoka Hospital, Tokyo, Japan.
Tokyo Cardiovascular Care Unit Network Scientific Committee, Tokyo, Japan.
J Cardiol. 2023 Aug;82(2):93-99. doi: 10.1016/j.jjcc.2022.12.011. Epub 2023 Jan 12.
Takotsubo syndrome (TTS) is an acute cardiovascular disease with clinical manifestations similar to those of acute myocardial infarction (AMI), and TTS sometimes occurs just after catastrophes. Large-scale studies of TTS in Japan are scarce, so we examined data over 9 years from Tokyo metropolitan acute cardiovascular care hospital network registry.
A total of 1626 patients were diagnosed with TTS between 2010 and 2018 at Tokyo Cardiovascular Care Unit Network facilities, and data from all these patients were analyzed. We investigated annual and monthly captured incidence of TTS, temporal trend of the captured incidence proportion of TTS versus AMI, the occurrence of TTS on the day of the great earthquake, and we elucidated the prognostic factors for in-hospital death.
The annual incidence proportion of TTS versus AMI increased from 2.3 % to 4.5 % (p < 0.001) over 9 years. The mean TTS patient age was 74.4 years: the peak incidence of TTS was at 80 to 84 years of age for both male and female; females accounted for 78.5 % of patients. The monthly variation of the incidence of TTS was found (p = 0.009). In 2011, a total of 137 cases of TTS occurred, with as many as 6 occurring on March 11, the day of the Great East Japan Earthquake. There was a definable trigger for TTS in 64 % (physical: 36 %; emotional: 27 %; others: 2 %). All-cause in-hospital mortality was 5.3 % and was higher in males than in females (10.3 % vs 3.9 %; p < 0.001). Non-cardiac causes accounted for 62 % of in-hospital mortality. Factors at presentation that were associated with in-hospital all-cause mortality were male sex, low body mass index, and a high C-reactive protein level.
This study elucidated the clinical features, in-hospital outcomes, and their attributed factors in patients with TTS in real-world clinical practice in Japan.
心尖球囊综合征（TTS）是一种具有类似急性心肌梗死（AMI）临床表现的急性心血管疾病，且 TTS 有时会在灾难后发生。日本对 TTS 的大规模研究很少，因此我们检查了东京都急性心血管治疗医院网络登记处 9 年来的数据。
2010 年至 2018 年期间，东京心血管护理网络设施共诊断出 1626 例 TTS 患者，对所有这些患者的数据进行了分析。我们调查了 TTS 的年捕获发病率和月捕获发病率，TTS 与 AMI 的捕获发病率比例的时间趋势，特大地震当天 TTS 的发生情况，并阐明了院内死亡的预后因素。
9 年来，TTS 与 AMI 的年发病率比例从 2.3%增加到 4.5%（p<0.001）。TTS 患者的平均年龄为 74.4 岁：男性和女性的 TTS 发病高峰年龄均为 80 至 84 岁；女性占患者的 78.5%。发现 TTS 发病率存在月度变化（p=0.009）。2011 年共发生 TTS 137 例，其中 6 例发生在东日本大地震当天 3 月 11 日。64%（物理因素：36%；情绪因素：27%；其他因素：2%）的 TTS 有明确的诱因。全因院内死亡率为 5.3%，男性高于女性（10.3%比 3.9%；p<0.001）。非心脏原因占院内死亡的 62%。与院内全因死亡率相关的就诊时因素为男性、低体重指数和高 C 反应蛋白水平。
本研究阐明了日本真实临床实践中 TTS 患者的临床特征、院内结局及其相关因素。
