title: Differences in clinical features and in-hospital outcomes of older adults with tako-tsubo cardiomyopathy.
abstract: OBJECTIVE
  To describe the clinical characteristics and in-hospital outcomes of older adults with tako-tsubo cardiomyopathy (TTC).
  
  
  METHODS
  Partially retrospective, partially prospective observational study.
  
  
  METHODS
  Eleven Italian referral cardiac centers included in the Tako-tsubo Italian Network.
  
  
  METHODS
  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).
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Cardiology, University Hospital San Giovanni di Dio e Ruggi d'Aragona, Salerno 84100, Italy.rodolfocitro@teletu.it
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Citro
authors.forename: Fausto
authors.initials: F
authors.lastname: Rigo
authors.forename: Mario
authors.initials: M
authors.lastname: Previtali
authors.forename: Quirino
authors.initials: Q
authors.lastname: Ciampi
authors.forename: Francesco Antonini
authors.initials: FA
authors.lastname: Canterin
authors.forename: Gennaro
authors.initials: G
authors.lastname: Provenza
authors.forename: Roberta
authors.initials: R
authors.lastname: Giudice
authors.forename: Marco Mariano
authors.initials: MM
authors.lastname: Patella
authors.forename: Olga
authors.initials: O
authors.lastname: Vriz
authors.forename: Rahul
authors.initials: R
authors.lastname: Mehta
authors.forename: Cesare
authors.initials: C
authors.lastname: Baldi
authors.forename: Rajendra H
authors.initials: RH
authors.lastname: Mehta
authors.forename: Eduardo
authors.initials: E
authors.lastname: Bossone
mesh_terms: D000368:Aged; D019468:Disease Management; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D015994:Incidence; D007297:Inpatients; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D012042:Registries; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D054549:Takotsubo Cardiomyopathy / Q000453:epidemiology / Q000628:therapy*