Background: 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 3 piece horse wall art patients and furthermore, TTS patients with concomitant KF experience more adverse events compared to myocardial infarction (MI) patients with concomitant KF.Methods and Results: This retrospective single-center study comprised two groups (cohorts) of patients including patients with TTS and concomitant KF (n = 61, 27.1%) and patients with MI and concomitant KF (n = 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 knowall.blog 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%, p = 0.
02) and 5 years (34.4% vs.20.7%, p = 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.Conclusions: 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.