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Differences in Clinical Features and In‐Hospital Outcomes of Older Adults with Tako‐Tsubo Cardiomyopathy
Author(s) -
Citro Rodolfo,
Rigo Fausto,
Previtali Mario,
Ciampi Quirino,
Canterin Francesco Antonini,
Provenza Gennaro,
Giudice Roberta,
Patella Marco Mariano,
Vriz Olga,
Mehta Rahul,
Baldi Cesare,
Mehta Rajendra H.,
Bossone Eduardo
Publication year - 2012
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2011.03730.x
Subject(s) - medicine , ejection fraction , hazard ratio , cardiogenic shock , heart failure , cardiomyopathy , tertiary referral hospital , stroke (engine) , confidence interval , cardiology , myocardial infarction , pediatrics , retrospective cohort study , mechanical engineering , engineering
Objectives To describe the clinical characteristics and in‐hospital outcomes of older adults with tako‐tsubo cardiomyopathy ( TTC ). Design Partially retrospective, partially prospective observational study. Setting Eleven Italian referral cardiac centers included in the Tako‐tsubo Italian Network. Participants One hundred ninety consecutive individuals with TTC (92.1% female, mean age 66) were divided into three groups according to age (<65, n = 78; 65–74, n = 61; ≥75, n = 51). Measurements Clinical findings and in‐hospital outcomes were evaluated in each group. Results Participants aged 65 and older had a greater prevalence of hypertension ( P = .001) and a lower glomerular filtration rate ( P < .001), and those aged 65 to 74 had a greater prevalence of psychiatric disorders ( P = .01), ST ‐segment elevation on admission ( P = .01) and a cerebrovascular disease ( P = .003) than those younger than 65. Despite similar left ventricular ejection fraction ( LVEF ) on admission ( P = .26), the oldest group had a lower LVEF at discharge ( P = .03). Inotropic agents were used more frequently in older adults ( P = .03). In‐hospital composite adverse events (all‐cause death, acute heart failure, life‐threatening arrhythmias, stroke, and cardiogenic shock; P = .03) and overall complications ( P = .004) were more common in participants aged 75 and older. Overall in‐hospital mortality was low (2.8%) but was more prevalent in participants aged 75 and older (6.3%). On multivariate analysis, age of 75 and older (hazard ratio ( HR ) = 2.45, 95% confidence interval ( CI ) = 1.28–5.82, P = .04) and LVEF on admission ( HR = 0.874, 95% CI = 0.81–0.95, P < .001) were the only independent predictors of in‐hospital adverse events. Conclusion The clinical profile of participants aged 75 and older with TTC was different from that of those younger than 75 with TTC , and they had a higher in‐hospital complication rate.