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Inicio Medicina Clínica (English Edition) Heart rate disorders in patients with Tako-tsubo syndrome
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Vol. 161. Issue 8.
Pages 330-337 (October 2023)
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Vol. 161. Issue 8.
Pages 330-337 (October 2023)
Original article
Heart rate disorders in patients with Tako-tsubo syndrome
Trastornos del ritmo cardiaco en pacientes con sindrome de Tako-tsubo
Oscar Vediaa,b,
Corresponding author
oscarvediacruz@gmail.com

Corresponding author.
, Manuel Almendro-Deliac, Javier López-Paísd, Alberto Pérez-Castellanose, Aitor Uribarrif, Albert Duran-Cambrag, Agustín Martín-Garcíah, Iván J. Núñez-Gila,b, on behalf of the working group
a Instituto Cardiovascular, Hospital Clínico San Carlos, Madrid, Spain
b Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, Villaviciosa de Odón, Madrid, Spain
c Servicio de Cardiología, Hospital Universitario Virgen Macarena, Sevilla, Spain
d Servicio de Cardiología, Hospital Clínico Universitario de Santiago, Ourense, Spain
e Servicio de Cardiología, Instituto de Investigación Sanitaria Islas Baleares (IdISBa), Hospital Universitario Son Espases, Palma, Spain
f Vall d’Hebron Institut de Recerca (VHIR), CIBER-CV, Hospital Universitari Vall d‘Hebron, Barcelona, Spain
g Servicio de Cardiología, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
h Servicio de Cardiología, Complejo Asistencial Universitario de Salamanca, Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Salamanca, Spain
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Figures (2)
Tables (4)
Table 1. Characterisation of patients with Tako-tsubo syndrome and rhythm disorders (arrhythmia group).
Table 2. Rhythm and conduction disturbances during hospital stay in patients with Tako-tsubo syndrome.
Table 3. Peri-hospital pharmacological treatment in patients with Tako-tsubo syndrome and rhythm disorders.
Table 4. Comparison after matching by propensity score.
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Additional material (1)
Abstract
Objectives

This study sought to evaluate the incidence, prognosis and treatment of heart rhythm disorders (TdR) in Tako-tsubo syndrome (STT).

Background

STT is associated with TdR. The TdR prognostic value is not well characterized in STT yet.

Methods

The TdR of patients included in the National Registry of Tako-tsubo syndrome (XXX1), admitted between 2002 and 2018 and coming from 38 hospitals throughout the country, was analyzed. We analyzed any heart rhythm disorder in patients presented before admission, at admission and in long-term follow-up.

Results

All types of TdR were described in 259 (23.5%) cases, from a cohort of 1,097 consecutive patients with STT. TdR was more associated with Diabetes Mellitus, smoking, hyperuricemia, sleep apnea, anemia with a worse LVEF on admission. The most frequent TdR was a new onset of atrial fibrillation (FA). During hospitalization, patients with TdR showed more complications such as shock on admission, major bleeding, acute renal failure, and combined infections. At follow-up, they presented higher mortality and more MACE, but with a non-significant correlation.

Conclusions

The incidence of TdR in patients with STT is not infrequent. STT, when associated with TdR, presents more complications and a worse prognosis both in hospital and in the long term.

Keywords:
Tako-tsubo syndrome
Acute coronary syndrome
Arrhythmias
Rhythm and conduction disorders
Heart failure
Atrial fibrillation
Left ventricular dysfunction
Resumen
Objetivo

El presente estudio pretende evaluar la incidencia, pronóstico y tratamiento de los trastornos del ritmo (TdR) en el síndrome de Tako-tsubo (STT).

Antecedentes

El STT se asocia frecuentemente a TdR. El valor pronóstico de estos TdR aún no está bien caracterizado en el STT.

Material y métodos

Se analizaron los TdR de los pacientes incluidos en el REgistro nacional de síndrome de Tako-tsubo (XXX1), ingresados entre 2002 y 2018, aportados por 38 hospitales de todo el país. Analizamos en los pacientes TdR previos, en el ingreso y en el seguimiento a largo plazo.

Resultados

Se describió cualquier tipo de TdR en 259 (23,5%) casos, de una cohorte de 1.097 pacientes consecutivos con STT. Los TdR se presentan más en pacientes con diabetes mellitus, tabaquismo, hiperuricemia, apnea del sueño y anemia, además de con una FEVI menor al ingreso. El TdR más frecuente fue el debut de fibrilación auricular (FA). Durante el ingreso hospitalario, los pacientes con TdR mostraron más complicaciones, como shock al ingreso, sangrado mayor, insuficiencia renal aguda y el combinado de infecciones. En el seguimiento, presentaron mayor mortalidad y numéricamente más eventos adversos combinados.

Conclusiones

Los trastornos del ritmo no son infrecuentes en fase aguda del síndrome de Tako-tsubo. El STT asociado a TdR se presenta con más complicaciones y peor pronóstico tanto hospitalario como a largo plazo.

Palabras clave:
Síndrome de Tako-tsubo
Síndrome coronario agudo
Arritmias
Trastornos del ritmo y la conducción
Insuficiencia cardiaca
Fibrilación auricular
Disfunción ventricular izquierda

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