General medicine department and Internal Medicine Outpatient Clinic, Jakobstad, Finland.
Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark.
Int J Cardiol. 2023 Dec 1;392:131283. doi: 10.1016/j.ijcard.2023.131283. Epub 2023 Aug 22.
Previous small-scale studies have indicated a short-term stroke incidence of 1.0-1.3% following Takotsubo (syndrome). In this nationwide register-based study, we investigated the 90-day risk of ischemic stroke (IS) or transient ischemia attack (TIA) and mortality of patients with Takotsubo.
Patients with incident Takotsubo between January 1st 2009 to September 30th 2018 were identified from Danish nationwide registries. Takotsubo patients were age- and sex-matched with background-, atrial fibrillation/flutter- (AF) and myocardial infarction (MI) cohorts. Cumulative incidences and Cox proportional-hazard regression models were used to analyze the following outcomes: 1) composite of IS/TIA and 2) all-cause mortality. A total of 890 patients with Takotsubo were followed for 90 days. The cumulative 90-day incidence of IS/TIA in the Takotsubo-, background-, AF- and MI cohort, was 2.1% (n = 19), 0.1% (n = 4), 1.1% (n = 47) and 1.5% (n = 66), respectively. The cumulative 90-day mortality in the Takotsubo-, background-, AF- and MI cohort was 5.1% (n = 45), 0.3% (n = 13), 1.7% (n = 75) and 5.6% (n = 230), respectively. The adjusted hazard ratio (HR) for 90-day IS/TIA was when compared to the background-, AF- and MI cohort, 26.43 (95% CI: 8.82-79.24), 1.91 (95% CI: 1.09-3.35) and 2.06 (95% CI: 1.12-3.79), respectively. The adjusted HR for 90-day mortality was when compared to the background-, AF- and MI cohort, 14.19 (95% CI: 7.43-27.09), 0.73 (95% CI: 0.52-1.02) and 1.96 (95% CI: 1.25-3.07), respectively.
Patients with Takotsubo had an increased 90-day hazard for IS/TIA when compared to age- and sex-matched background-, AF- and MI cohorts.
先前的小规模研究表明，Takotsubo（综合征）后短期中风发病率为 1.0-1.3%。在这项全国范围内基于登记的研究中，我们调查了 Takotsubo 患者 90 天内缺血性中风（IS）或短暂性脑缺血发作（TIA）和死亡率的风险。
从丹麦全国登记处确定了 2009 年 1 月 1 日至 2018 年 9 月 30 日期间发生 Takotsubo 的患者。Takotsubo 患者与背景、心房颤动/扑动（AF）和心肌梗死（MI）队列按年龄和性别匹配。累积发生率和 Cox 比例风险回归模型用于分析以下结果：1）IS/TIA 复合和 2）全因死亡率。共有 890 名 Takotsubo 患者随访 90 天。Takotsubo、背景、AF 和 MI 队列的 90 天累积 IS/TIA 发生率分别为 2.1%（n=19）、0.1%（n=4）、1.1%（n=47）和 1.5%（n=66）。Takotsubo、背景、AF 和 MI 队列的 90 天死亡率分别为 5.1%（n=45）、0.3%（n=13）、1.7%（n=75）和 5.6%（n=230）。与背景、AF 和 MI 队列相比，90 天 IS/TIA 的调整后的危险比（HR）分别为 26.43（95%CI：8.82-79.24）、1.91（95%CI：1.09-3.35）和 2.06（95%CI：1.12-3.79）。与背景、AF 和 MI 队列相比，90 天死亡率的调整 HR 分别为 14.19（95%CI：7.43-27.09）、0.73（95%CI：0.52-1.02）和 1.96（95%CI：1.25-3.07）。
与年龄和性别匹配的背景、AF 和 MI 队列相比，Takotsubo 患者 90 天内发生 IS/TIA 的风险增加。
