Age-related differences in cardiogenic shock secondary to Takotsubo syndrome

BACKGROUND: Age-related differences in Takotsubo Syndrome (TTS) have been described, but there is limited information regarding TTS patients who develop cardiogenic shock (CS). METHODS AND RESULTS: We analysed data from 408 CS-TTS patients in the RETAKO registry. Patients were stratified into three...

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Bibliographic Details
Authors: Tomasino, Marco, Vazirani, Ravi, Salamanca, Jorge, Raposeiras-Roubin, Sergio, Fernández-Cordón, Clara, Corbí-Pascual, Miguel, Vedia, Oscar, Martín-García, Agustín C, Blanco-Ponce, Emilia, Almendro Delia, Manuel, Piserra-López, Alberto, Larre Guerra, Jaime Francisco, Gonzalez-Santorum, Francisco, Lluch-Requerey, Carmen, Guillén-Marzo, Marta, Pérez-Castellanos, Alberto, Ridocci-Soriano, Francisco, Lopez-País, Javier, Andrea, Rut, Sionis, Alessandro, Núñez-Gil, Iván J, Uribarri, Aitor
Format: article
Publication Date:2025
Country:España
Institution:Conselleria de Salut i Consum del Govern de les Illes Balears
Repository:Docusalut
Language:English
OAI Identifier:oai:docusalut.com:20.500.13003/25931
Online Access:https://hdl.handle.net/20.500.13003/25931
Access Level:Open access
Keyword:Takotsubo Cardiomyopathy
Shock, Cardiogenic
Heart Failure
Ventricular Dysfunction, Left
Cardiomiopatía de Takotsubo
Choque Cardiogénico
Insuficiencia Cardíaca
Disfunción Ventricular Izquierda
Takotsubo
age‐related differences
cardiogenic shock
heart failure
left ventricular dysfunction
stress cardiomyopathy
Description
Summary:BACKGROUND: Age-related differences in Takotsubo Syndrome (TTS) have been described, but there is limited information regarding TTS patients who develop cardiogenic shock (CS). METHODS AND RESULTS: We analysed data from 408 CS-TTS patients in the RETAKO registry. Patients were stratified into three age groups: ≤50 years (9%), 51-74 years (48%), and ≥75 years (43%). In the youngest group, compared to the middle-aged and the oldest groups, patients were more likely to be male (35% vs. 16% and 14%, p = .01), have a physical trigger (65% vs. 43% and 49%, p = .04), exhibit atypical echocardiographic patterns (27% vs. 11% and 11%, p = .02), and experienced a higher incidence of ventricular arrhythmias (24% vs. 8% and 7%, p = .01). In-hospital mortality rates were 5% in younger patients, 12% in middle-aged patients, and 15% in older patients (p = .15). Older age independently predicted both in-hospital mortality (OR 2.33, 95% CI 1.05-5.17; reference: middle-aged) and 5-year mortality (HR 3.69, 95% CI 1.77-7.67), regardless of shock severity. CONCLUSIONS: In CS-TTS, younger patients exhibit distinct clinical features but have better outcomes. Older age is associated with higher in-hospital and long-term mortality, regardless of comorbidities and shock severity. These findings underscore the need for age-specific management strategies and further research into the mechanisms underlying age-related differences in CS-TTS.

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