Osawa Takumi, Tajiri Kazuko, Ieda Masaki, Ishizu Tomoko
Department of Cardiology, Institute of Medicine, University of Tsukuba, Tsukuba, Japan.
Department of Cardiology, Tsukuba Medical Center Hospital, Tsukuba, Japan.
Front Cardiovasc Med. 2023 Sep 29;10:1244808. doi: 10.3389/fcvm.2023.1244808. eCollection 2023.
Recent studies suggested a relationship between Takotsubo syndrome (TTS) and malignancy. However, clinical outcomes of TTS associated with cancer have not been assessed completely. This study was aimed to investigate the outcomes of patients with TTS and cancer.
We performed a systematic review and meta-analysis to evaluate the clinical outcomes of TTS in patients with and without malignancy. We systematically reviewed and analyzed 14 studies (189,210 patients) published in PubMed and Cochrane Library databases until December 2022. The primary outcome was all-cause mortality at the longest follow-up.
The prevalence of current or previous malignancy in patients with TTS was 8.7% (16,461 patients). Patients with TTS and malignancy demonstrated a higher risk of mortality at the longest follow-up than those with TTS alone (odds ratio [OR], 2.41; 95% confidence interval [CI]; 1.95-2.98; < 0.001). Moreover, cancer was significantly associated with an increased risk of in-hospital or 30-day mortality (OR 2.36; 95% CI, 1.67-3.33; < 0.001), shock (OR 1.42; 95% CI, 1.30-1.55; < 0.001), mechanical respiratory support (OR 1.68; 95% CI, 1.59-1.77; < 0.001), arrhythmia (OR 1.27; 95% CI, 1.21-1.34; < 0.001), and major adverse cardiac events (OR 1.69; 95% CI, 1.18-2.442; < 0.001).
This study revealed significant associations between previous or active cancer and an increased risk of all-cause mortality and in-hospital adverse events in patients with TTS.
近期研究表明应激性心肌病（TTS）与恶性肿瘤之间存在关联。然而，与癌症相关的TTS的临床结局尚未得到全面评估。本研究旨在调查TTS合并癌症患者的结局。
我们进行了一项系统评价和荟萃分析，以评估合并或未合并恶性肿瘤的TTS患者的临床结局。我们系统回顾并分析了截至2022年12月在PubMed和Cochrane图书馆数据库中发表的14项研究（189,210例患者）。主要结局是最长随访期的全因死亡率。
TTS患者中当前或既往患有恶性肿瘤的患病率为8.7%（16,461例患者）。与单纯TTS患者相比，合并恶性肿瘤的TTS患者在最长随访期的死亡风险更高（比值比[OR]，2.41；95%置信区间[CI]：1.95-2.98；P<0.001）。此外，癌症与住院或30天死亡率增加（OR 2.36；95% CI，1.67-3.33；P<0.001）、休克（OR 1.42；95% CI，1.30-1.55；P<0.001）、机械通气支持（OR 1.68；95% CI，1.59-1.77；P<0.001）、心律失常（OR 1.27；95% CI，1.21-1.34；P<0.001）以及主要不良心脏事件（OR 1.69；95% CI，1.18-2.442；P<0.001）显著相关。
本研究揭示了既往或活动性癌症与TTS患者全因死亡率增加及住院不良事件之间存在显著关联。
