Incidence of takotsubo syndrome in patients with acute coronary syndrome: A single PCI center experience - A 7-years retrospective analysis

Title Alternative:Incidence Takotsubo syndromu u pacientu s akutním koronárním syndromem: retrospektivní 7letá analýza jednoho PCI centra
Takotsubo syndrome is manifested with acute heart failure and resembles acute coronary syndrome, truly mimicking its clinical and ECG features. It is characterized by transient contractility disorder of predominantly the apical part of the left ventricle without any presence of occlusive coronary disease. It is found in 1-2% of patients admitted to hospital for acute coronary syndrome. The prognosis has so far been considered to be benign with complete recovery of the left ventricle within several weeks; however recent information from a large registry of this syndrome (InterTAK) has shown the short - and long-term prognosis to be the same as in patients suffering from acute coronary syndrome. The etiology is unknown and treatment is symptomatic only. Transient dynamic left ventricular outflow tract obstruction as well as hemodynamic instability and arrhythmias can sometimes be present. Aim of study: Retrospective analysis of the incidence and clinical course of takotsubo syndrome (TS) in patients with acute coronary syndrome (ACS) in a single PCI centre during an 84-month period. Results: A total of 2 298 urgent coronary angiography procedures were performed in patients presenting with ACS. The diagnosis of TS was established in 21 (0.9 %), with the majority of patients being female - 20 (95 %). The mean age was 63.7 ± 10.5 (49-84) years; ac- cording to ECG, there were 9 (43 %) STEMI and 12 (57 %) NSTEMI cases. The mean value of left ventricular ejection fraction (LVEF) was 47 ± 9.1 % (35-65 %). After one month, a complete restoration of LVEF was found in all patients undergoing follow-up (86 %) with a mean LVEF of 63.5 ± 8.9 % (50-80 %). None of the patients died within one month after the diagnosis of TS syndrome. Conclusion: Our experience confirms a low incidence of TS in patients with ACS. However, our study population is too small to obtain a valid conclusion on short-term prognosis.
Acute coronary syndrome, Complication, Etiology, Incidence, Prognosis, Takotsubo syndrome, Treatment