Kidney Failure among Patients with Takotsubo Syndrome or Myocardial Infarction: A Retrospective Analysis
<b>Background:</b> Takotsubo syndrome (TTS) is a syndrome with ambiguous pathophysiology. Impaired kidney function (KF) seems to impact the outcome of patients with TTS. We hypothesized that KF worsens the outcome among TTS patients and furthermore, TTS patients with concomitant KF exper...
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| Format: | Article |
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MDPI AG
2022-06-01
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| Series: | Journal of Cardiovascular Development and Disease |
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| Online Access: | https://www.mdpi.com/2308-3425/9/6/186 |
| _version_ | 1797486067223363584 |
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| author | Verena Bill Ibrahim El-Battrawy Marvin Kummer Andreas Mügge Assem Aweimer Michael Behnes Ibrahim Akin |
| author_facet | Verena Bill Ibrahim El-Battrawy Marvin Kummer Andreas Mügge Assem Aweimer Michael Behnes Ibrahim Akin |
| author_sort | Verena Bill |
| collection | DOAJ |
| description | <b>Background:</b> Takotsubo syndrome (TTS) is a syndrome with ambiguous pathophysiology. Impaired kidney function (KF) seems to impact the outcome of patients with TTS. We hypothesized that KF worsens the outcome among TTS patients and furthermore, TTS patients with concomitant KF experience more adverse events compared to myocardial infarction (MI) patients with concomitant KF. <b>Methods and Results:</b> This retrospective single-center study comprised two groups (cohorts) of patients including patients with TTS and concomitant KF (<i>n</i> = 61, 27.1%) and patients with MI and concomitant KF (<i>n</i> = 164, 72.9%). The clinical outcomes were delineated as short-term outcomes defined as in-hospital adverse events during index hospitalization and long-term outcomes defined as adverse events over five-year clinical follow-ups. All-cause mortality, stroke, cardiopulmonary resuscitation (CPR), life-threatening arrhythmias, need for respiratory support, and cardiogenic shock with subsequent use of inotropic agents during index hospitalization were denoted as in-hospital adverse events. All-cause mortality, rehospitalization due to heart failure, stroke, thromboembolic events, and the recurrence of primary pathology (TTS and MI) were analyzed during five-year follow-ups after index hospitalization. A higher mortality rate was noted among TTS patients with KF compared to TTS without KF. In addition, in-hospital event rates in patients with TTS and concomitant KF compared to MI and concomitant KF were comparable with the exception of a higher rate of respiratory support in TTS patients. The mortality rate was significantly higher among patients with TTS and KF at 4 years (29.5% vs. 15.9%, <i>p</i> = 0.02) and 5 years (34.4% vs. 20.7%, <i>p</i> = 0.03) in comparison to patients with MI and concomitant KF. In contrast, the rate of re-hospitalization related to heart failure was higher at 30 days, and at one-, four-, and five-year follow-ups in patients suffering from MI and KF compared to TTS and concomitant KF. Additionally, the recurrence of MI after 4 and 5 years was higher than the recurrence of TTS (4.9% vs. 15.2%; 4.9% vs. 16.5%). There were no differences in life-threatening arrhythmias and stroke in both groups. <b>Conclusions:</b> Patients with TTS and concomitant KF have higher all-cause mortality when compared to MI and concomitant KF. The mechanisms responsible remain to be determined. |
| first_indexed | 2024-03-09T23:28:53Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 2308-3425 |
| language | English |
| last_indexed | 2024-03-09T23:28:53Z |
| publishDate | 2022-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Cardiovascular Development and Disease |
| spelling | doaj.art-04d208cd21184f9099dc47dff492693a2023-11-23T17:12:39ZengMDPI AGJournal of Cardiovascular Development and Disease2308-34252022-06-019618610.3390/jcdd9060186Kidney Failure among Patients with Takotsubo Syndrome or Myocardial Infarction: A Retrospective AnalysisVerena Bill0Ibrahim El-Battrawy1Marvin Kummer2Andreas Mügge3Assem Aweimer4Michael Behnes5Ibrahim Akin6Department of Cardiology, Wiesbaden Hospital, 65189 Wiesbaden, GermanyBergmannsheil Bochum, Medical Clinic II, Department of Cardiology and Angiology, Ruhr University, 44789 Bochum, GermanyFirst Department of Medicine Cardiology, University Medical Centre Mannheim (UMM), Faculty of Medicine Mannheim, University of Heidelberg, DZHK (German Center for Cardiovascular Research) Partner Site Mannheim, 68167 Mannheim, GermanyBergmannsheil Bochum, Medical Clinic II, Department of Cardiology and Angiology, Ruhr University, 44789 Bochum, GermanyBergmannsheil Bochum, Medical Clinic II, Department of Cardiology and Angiology, Ruhr University, 44789 Bochum, GermanyFirst Department of Medicine Cardiology, University Medical Centre Mannheim (UMM), Faculty of Medicine Mannheim, University of Heidelberg, DZHK (German Center for Cardiovascular Research) Partner Site Mannheim, 68167 Mannheim, GermanyFirst Department of Medicine Cardiology, University Medical Centre Mannheim (UMM), Faculty of Medicine Mannheim, University of Heidelberg, DZHK (German Center for Cardiovascular Research) Partner Site Mannheim, 68167 Mannheim, Germany<b>Background:</b> Takotsubo syndrome (TTS) is a syndrome with ambiguous pathophysiology. Impaired kidney function (KF) seems to impact the outcome of patients with TTS. We hypothesized that KF worsens the outcome among TTS patients and furthermore, TTS patients with concomitant KF experience more adverse events compared to myocardial infarction (MI) patients with concomitant KF. <b>Methods and Results:</b> This retrospective single-center study comprised two groups (cohorts) of patients including patients with TTS and concomitant KF (<i>n</i> = 61, 27.1%) and patients with MI and concomitant KF (<i>n</i> = 164, 72.9%). The clinical outcomes were delineated as short-term outcomes defined as in-hospital adverse events during index hospitalization and long-term outcomes defined as adverse events over five-year clinical follow-ups. All-cause mortality, stroke, cardiopulmonary resuscitation (CPR), life-threatening arrhythmias, need for respiratory support, and cardiogenic shock with subsequent use of inotropic agents during index hospitalization were denoted as in-hospital adverse events. All-cause mortality, rehospitalization due to heart failure, stroke, thromboembolic events, and the recurrence of primary pathology (TTS and MI) were analyzed during five-year follow-ups after index hospitalization. A higher mortality rate was noted among TTS patients with KF compared to TTS without KF. In addition, in-hospital event rates in patients with TTS and concomitant KF compared to MI and concomitant KF were comparable with the exception of a higher rate of respiratory support in TTS patients. The mortality rate was significantly higher among patients with TTS and KF at 4 years (29.5% vs. 15.9%, <i>p</i> = 0.02) and 5 years (34.4% vs. 20.7%, <i>p</i> = 0.03) in comparison to patients with MI and concomitant KF. In contrast, the rate of re-hospitalization related to heart failure was higher at 30 days, and at one-, four-, and five-year follow-ups in patients suffering from MI and KF compared to TTS and concomitant KF. Additionally, the recurrence of MI after 4 and 5 years was higher than the recurrence of TTS (4.9% vs. 15.2%; 4.9% vs. 16.5%). There were no differences in life-threatening arrhythmias and stroke in both groups. <b>Conclusions:</b> Patients with TTS and concomitant KF have higher all-cause mortality when compared to MI and concomitant KF. The mechanisms responsible remain to be determined.https://www.mdpi.com/2308-3425/9/6/186cardiomyopathytakotsuboheart failuredeathkidneystress |
| spellingShingle | Verena Bill Ibrahim El-Battrawy Marvin Kummer Andreas Mügge Assem Aweimer Michael Behnes Ibrahim Akin Kidney Failure among Patients with Takotsubo Syndrome or Myocardial Infarction: A Retrospective Analysis Journal of Cardiovascular Development and Disease cardiomyopathy takotsubo heart failure death kidney stress |
| title | Kidney Failure among Patients with Takotsubo Syndrome or Myocardial Infarction: A Retrospective Analysis |
| title_full | Kidney Failure among Patients with Takotsubo Syndrome or Myocardial Infarction: A Retrospective Analysis |
| title_fullStr | Kidney Failure among Patients with Takotsubo Syndrome or Myocardial Infarction: A Retrospective Analysis |
| title_full_unstemmed | Kidney Failure among Patients with Takotsubo Syndrome or Myocardial Infarction: A Retrospective Analysis |
| title_short | Kidney Failure among Patients with Takotsubo Syndrome or Myocardial Infarction: A Retrospective Analysis |
| title_sort | kidney failure among patients with takotsubo syndrome or myocardial infarction a retrospective analysis |
| topic | cardiomyopathy takotsubo heart failure death kidney stress |
| url | https://www.mdpi.com/2308-3425/9/6/186 |
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