Prognostic Utility of Society for Cardiovascular Angiography and Interventions Shock Stage Approach for Classifying Cardiogenic Shock Severity in Takotsubo Syndrome

Cardiogenic shock (CS) is a significant complication of Takotsubo syndrome (TTS), contributing to heightened mortality and morbidity. Despite this, the Society for Cardiovascular Angiography and Interventions (SCAI) staging system for CS severity lacks validation in patients with TTS and CS. This st...

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Detalles Bibliográficos
Autores: Camblor-Blasco, Andrea, Nuñez-Gil, Ivan Javier|||0000-0002-1779-3102, Duran Cambra, Albert|||0000-0002-5692-6844, Almendro-Delia, Manuel|||0000-0001-7144-4782, Ródenas-Alesina, Eduard|||0000-0003-1638-7820, Fernández-Cordon, Clara|||0000-0002-2492-2873, Vedia Cruz, Oscar|||0000-0001-5062-3335, Corbí-Pascual, Miguel|||0000-0001-5923-1290, Blanco, Emilia|||0000-0001-6157-679X, Raposeiras-Roubin, Sergio|||0000-0002-6462-4715, Guillén Marzo, Marta|||0000-0003-3345-2356, Sanchez Grande Flecha, Alejandro, Garcia Acuña, Jose Maria|||0000-0003-1406-4171, Salamanca, Jorge|||0000-0002-5067-5052, Escudier-Villa, Juan M.|||0000-0003-3603-8433, Martin-Garcia, Agustin C.|||0000-0001-8662-3791, Tomasino, Marco|||0000-0003-1989-4342, Vazirani Ballesteros, Ravi|||0000-0002-7337-0593, Pérez-Castellanos, Alberto|||0000-0002-5879-0012, Uribarri, Aitor|||0000-0002-6911-7480
Tipo de recurso: artículo
Fecha de publicación:2024
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:305880
Acceso en línea:https://ddd.uab.cat/record/305880
https://dx.doi.org/urn:doi:10.1161/JAHA.123.032951
Access Level:acceso abierto
Palabra clave:SCAI
Takotsubo syndrome
Cardiogenic shock
Extracorporeal membrane oxygenation
Heart failure
Descripción
Sumario:Cardiogenic shock (CS) is a significant complication of Takotsubo syndrome (TTS), contributing to heightened mortality and morbidity. Despite this, the Society for Cardiovascular Angiography and Interventions (SCAI) staging system for CS severity lacks validation in patients with TTS and CS. This study aimed to characterize a patient cohort with TTS using the SCAI staging system and assess its utility in cases of TTS complicated by CS. From a TTS national registry, 1591 consecutive patients were initially enrolled and stratified into 5 SCAI stages (A through E). Primary outcome was all-cause in-hospital mortality; secondary end points were TTS-related in-hospital complications and 1-year all-cause mortality. After exclusions, the final cohort comprised 1163 patients, mean age 71.0±11.8 years, and 87% were female. Patients were categorized across SCAI shock stages as follows: A 72.1%, B 12.2%, C 11.2%, D 2.7%, and E 1.8%. Significant variations in baseline demographics, comorbidities, clinical presentations, and in-hospital courses were observed across SCAI shock stages. After multivariable adjustment, each higher SCAI shock stage showed a significant association with increased in-hospital mortality (adjusted odds ratio: 1.77-29.31) compared with SCAI shock stage A. Higher SCAI shock stages were also associated with increased 1-year mortality. In a large multicenter patient cohort with TTS, the functional SCAI shock stage classification effectively stratified mortality risk, revealing a continuum of escalating shock severity with higher stages correlating with increased in-hospital mortality. This study highlights the applicability and prognostic value of the SCAI staging system in TTS-related CS.

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