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Impact of concomitant atrial fibrillation on the prognosis of Takotsubo cardiomyopathy

2016; Oxford University Press; Volume: 19; Issue: 8 Linguagem: Inglês

10.1093/europace/euw293

1532-2092

Ibrahim El‐Battrawy, Siegfried Lang, Uzair Ansari, Michael Behnes, Dennis Hillenbrand, Katja Schramm, Christian Fastner, Xiaobo Zhou, Verena Bill, Ursula Hoffmann, Theano Papavassiliu, Elif Elmas, Darius Haghi, Martin Borggrefe, İbrahim Akın,

Cardiac Structural Anomalies and Repair

Previous studies revealed that patients with Takotsubo cardiomyopathy (TTC) have a higher mortality rate than the general population. Supraventricular tachycardia is a well-known complication of TTC. This study was performed to determine the short- and long-term prognostic impact of atrial fibrillation associated with TTC patients. Our institutional database constituted a collective of 114 patients diagnosed with TTC from 2003 to 2015. The patients were divided into two groups according to the presence (n = 21, 18.4%) or absence (n = 93, 81.5%) of atrial fibrillation. The endpoint was a composite of in-hospital events (thromboembolic events and life-threatening arrhythmias), all-cause mortality, rehospitalization due to heart failure, stroke, and the recurrence of TTC. The in-hospital mortality, 30-day mortality, and long-term mortality were significantly higher in the atrial fibrillation group. Kaplan–Meier analysis indicated a significantly lower event-free survival rate over a mean follow-up of 3 years in the atrial fibrillation group than that in the non-atrial fibrillation group (log-rank, P < 0.01). In a multivariate cox regression analysis, atrial fibrillation (hazard ratio, HR 2.3, 95% confidence interval, CI: 1.1–4.9, P < 0.05) and EF ≤ 35% (HR 2.0, 95% CI: 1.1–3.8, P < 0.05) were the only independent predictors of a primary endpoint. Rates of in-hospital events and short- as well as long-term mortality were significantly higher in TTC patients suffering from atrial fibrillation compared with patients without atrial fibrillation.