People with Takotsubo syndrome (TTS), also known as broken heart syndrome, when triggered by emotions have a better disease outcome compared with physical triggers, finds a new study published in the Journal of the American College of Cardiology. Furthermore, TTS can either be benign or a life-threatening condition depending on the inciting stress factor.
Prognosis of TTS remains controversial due to limited availability of data. Additionally, the effect of the triggering factors remains elusive. Jelena R. Ghadri, University Hospital Zurich, Switzerland, and colleagues conducted the study to compare prognosis between TTS and acute coronary syndrome (ACS) patients and investigated short- and long-term outcomes in TTS based on different triggers.
For the study, the researchers enrolled patients with TTS from the International Takotsubo Registry. Long-term mortality of patients with TTS was compared to an age- and sex-matched cohort of patients with ACS. In addition, short- and long-term outcomes were compared between different groups according to triggering conditions.
- TTS patients had a comparable long-term mortality risk with ACS patients.
- Of 1,613 TTS patients, an emotional trigger was detected in 485 patients (30%).
- Of 630 patients (39%) related to physical triggers, 98 patients (6%) had acute neurologic disorders, while in the other 532 patients (33%), physical activities, medical conditions, or procedures were the triggering conditions.
- The remaining 498 patients (31%) had no identifiable trigger.
- TTS related to physical stress showed higher mortality rates than ACS patients during long-term follow-up, whereas those with TTS related to emotional stress had better outcomes compared with ACS patients.
“Our study reports that overall, TTS patients had a similar long-term outcome compared with age- and sex-matched ACS patient outcomes. TTS patients with events related to emotional stress appear to have a favorable short- and long-term prognosis, but TTS secondary to neurologic diseases have the worst short-term prognosis,” concluded the authors.
For further information log on to 10.1016/j.jacc.2018.06.016