Prevalence of cancer in Takotsubo cardiomyopathy: Short and long-term outcome

Abstract Background Takotsubo Cardiomyopathy (TTC) is a transient disorder of ventricular wall dysfunction, mostly induced by physical or emotional stress. TTC may be associated with adverse cardiac events. The association of cancer and its clinical impact in TTC patients has not been described yet....

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Published inInternational journal of cardiology Vol. 238; pp. 159 - 165
Main Authors Sattler, K, El-Battrawy, I, Lang, S, Zhou, X, Schramm, K, Tülümen, E, Kronbach, F, Röger, S, Behnes, M, Kuschyk, J, Borggrefe, M, Akin, I
Format Journal Article
LanguageEnglish
Published Netherlands Elsevier B.V 01.07.2017
Subjects
Aged
cancer
Cardiovascular
Female
Follow-Up Studies
Hospitalization - trends
Humans
Male
Middle Aged
Neoplasms - diagnosis
Neoplasms - mortality
Prevalence
prognosis
Risk Factors
Takotsubo Cardiomyopathy
Takotsubo Cardiomyopathy - diagnosis
Takotsubo Cardiomyopathy - mortality
Time Factors
Treatment Outcome
prognosis
cancer
Takotsubo Cardiomyopathy
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Summary:Abstract Background Takotsubo Cardiomyopathy (TTC) is a transient disorder of ventricular wall dysfunction, mostly induced by physical or emotional stress. TTC may be associated with adverse cardiac events. The association of cancer and its clinical impact in TTC patients has not been described yet. Methods In 114 consecutive patients presenting with TTC between January 2003 and September 2015, we studied the frequency of cancer diagnosis, and compared the clinical course and the occurrence of a clinical endpoint of cancer and non-cancer patients during a follow up of 4.2 years. Results Of the 114 patients, 16 (14.0%) had a malignancy already diagnosed at TTC, and further 11 patients received the diagnosis during follow up. Cancer patients had higher frequency of atrial fibrillation and lower hemoglobin levels at admission than patients without cancer. While the occurrence of in-hospital events was comparable, the diagnosis of cancer at TTC event or during follow up was predictive for a higher rate of the composite endpoint. In the Kaplan-Meier analysis, malignant diseases were strongly associated not only with overall mortality but also with worsened time of event-free survival during the long-term outcome. Conclusions Prevalence of malignant diseases is high in TTC patients, and is a risk factor for worse outcome. Screening for malignancies should be recommended in all patients presenting with TTC. Further studies are needed to define the association on molecular levels.
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ISSN:0167-5273
1874-1754
DOI:10.1016/j.ijcard.2017.02.093