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Tako-tsubo cardiomyopathy and coronary artery disease: a possible association.

Abstract：

BACKGROUND:In the medical literature, several cases of Tako-tsubo cardiomyopathy (TTC) with coronary artery disease (CAD) have been reported, and in clinical practice, several typical TTC cases show relevant stenoses of the coronary arteries spatially unrelated to the dysfunctional myocardium. OBJECTIVE:This study aimed to evaluate the prevalence, clinical characteristics, and outcome of patients with TTC and relevant CAD in a large multicenter database. METHODS:In 26 centers, 450 patients admitted with a diagnosis of TTC underwent coronary angiography within 48 h of hospital admission and were included prospectively in the Tako-tsubo Italian Network Registry. RESULTS:Overall, 43 (9.6%) patients had at least one relevant (≥50%) coronary stenosis not supplying the dysfunctional myocardium, whereas 407 patients (90.4%) had irrelevant stenosis or angiographically normal coronary arteries. TTC patients with relevant CAD were more likely to be older in age, to have diabetes, a familial history of CAD, and acute functional mitral regurgitation compared with those without relevant CAD. At the 6-month follow-up, the incidence of death, TTC recurrence, and rehospitalization rates in patients with and without relevant CAD were similar. On multivariable Cox analysis, an independent predictor of death was the Charlson Comorbidity Index, whereas the presence of CAD did not influence the mid-term outcome significantly. CONCLUSION:The presence of CAD is a rather common finding in a large proportion of patients with TTC. Thus, when the stenotic artery does not supply the dysfunctional myocardium or when the extent of dysfunctional myocardium is wider than the territory of distribution supplied by a single stenotic coronary artery, the presence of angiographically relevant CAD should not be considered an exclusion criterion for TTC.

journal_name

Coron Artery Dis

journal_title

Coronary artery disease

authors

Parodi G,Citro R,Bellandi B,Del Pace S,Rigo F,Marrani M,Provenza G,Leoncini M,Salerno Uriarte JA,Bovenzi F,Bossone E,Tako-tsubo Italian Network (TIN).

doi

10.1097/MCA.0b013e3283645c4e

subject

Has Abstract

pub_date

2013-09-01 00:00:00

pages

527-33

issue

eissn

0954-6928

issn

1473-5830

journal_volume

pub_type

杂志文章,多中心研究

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Tako-tsubo cardiomyopathy and coronary artery disease: a possible association.