Tomasino Marco, Núñez-Gil Iván J, Martínez-Selles Manuel, Vedia Oscar, Corbí-Pascual Miguel, Salamanca Jorge, Blanco-Ponce Emilia, Cordón Clara Fernández, Almendro-Delia Manuel, Pérez-Castellanos Alberto, Martín-García Agustín, Vila-Sanjuán Sofía, Vazirani Ravi, Duran-Cambra Albert, Becerra-Muñoz Victor M, Guillén-Marzo Marta, Uribarri Aitor
Department of Medicine Universitat Autònoma de Barcelona (UAB) Barcelona Spain.
Instituto Cardiovascular, Hospital Clínico San Carlos, Universidad Complutense Madrid Spain.
J Am Heart Assoc. 2024 Dec 3;13(23):e036800. doi: 10.1161/JAHA.124.036800. Epub 2024 Nov 29.
Sex-related differences in Takotsubo syndrome have been described, but no information is available in patients who develop cardiogenic shock.
Of 412 patients with Takotsubo syndrome with cardiogenic shock, 71 (17.2%) were men. Male patients were older (71.1±12.2 versus 65.3±17.1 years, <0.001), more frequently smokers (47 [66.2%] versus 66 [19.4%], <0.01), with higher prevalence of neoplasms (6 [8.5%] versus 8 [2.3%], =0.01), lower left ventricular ejection fraction (31% versus 37%, <0.001), more frequent invasive mechanical ventilation (30 [42.3%] versus 90 [26.4%], =<0.01), higher rate of infections (43 [60.6%] versus 148 [43.4%], =<0.01), and longer in-hospital stay (19±20 days versus 13±15 days, =0.02). A total of 55 patients (13.3%) died during hospital admission, and 90 patients (21.8%) died at the end of the 5-year follow-up. Male sex was not significantly associated with the in-hospital (odds ratio, 1.31 [95% CI, 0.64-2.68]) or 5-year mortality rate (hazard ratio, 1.66 [95% CI, 0.93-2.94]). In the matched cohort, no significant differences in the short- and long-term mortality rate were found either.
Cardiogenic shock due to Takotsubo syndrome has high short- and long-term mortality rates that are similar in men and women.
已有文献报道过应激性心肌病的性别差异，但对于发生心源性休克的患者，尚无相关信息。
在412例发生心源性休克的应激性心肌病患者中，男性71例（17.2%）。男性患者年龄更大（71.1±12.2岁 vs 65.3±17.1岁，<0.001），吸烟比例更高（47例[66.2%] vs 66例[19.4%]，<0.01），肿瘤患病率更高（6例[8.5%] vs 8例[2.3%]，=0.01），左心室射血分数更低（31% vs 37%，<0.001），有创机械通气更频繁（30例[42.3%] vs 90例[26.4%]，=<0.01），感染发生率更高（43例[60.6%] vs 148例[43.4%]，=<0.01），住院时间更长（19±20天 vs 13±15天，=0.02）。共有55例患者（13.3%）在住院期间死亡，90例患者（21.8%）在5年随访结束时死亡。男性与住院死亡率（优势比，1.31[95%CI，0.64 - 2.68]）或5年死亡率（风险比，1.66[95%CI，0.93 - 2.94]）无显著相关性。在匹配队列中，短期和长期死亡率也无显著差异。
应激性心肌病所致的心源性休克有较高的短期和长期死亡率，且男女相似。
