APACHE II score, rather than cardiac function, may predict poor prognosis in patients with stress-induced cardiomyopathy.
While the disease course of stress-induced cardiomyopathy (SIC) is usually benign, it can be fatal. The prognostic factors to predict poorer outcome are not well established, however. We analyzed the Acute Physiology And Chronic Health Evaluation (APACHE) II score to assess its value for predicting poor prognosis in patients with SIC. Thirty-seven consecutive patients with SIC were followed prospectively during their hospitalization. Clinical factors, including APACHE II score, coronary angiogram, echocardiography and cardiac enzymes at presentation were analyzed. Of the 37 patients, 27 patients (73%) were women. The mean age was 66.1 ± 15.6 yr, and the most common presentation was chest pain (38%). Initial echocardiographic left ventricular ejection fraction (EF) was 42.5% ± 9.3%, and the wall motion score index (WMSI) was 1.9 ± 0.3. Six patients (16%) expired during the follow-up period of hospitalization. Based on the analysis of characteristics and clinical factors, the only predictable variable in prognosis was APACHE II score. The patients with APACHE II score greater than 20 had tendency to expire than the others (P = 0.001). Based on present study, APACHE II score more than 20, rather than cardiac function, is associated with mortality in patients with SIC.
Department of Internal Medicine, Kyung-Hee University, School of Medicine, Seoul, Korea.
Byung-Hyun
BH
Joe
Uk
U
Jo
Hyun-Soo
HS
Kim
Chang-Bum
CB
Park
Hui-Jeong
HJ
Hwang
Il-Suk
IS
Sohn
Eun-Sun
ES
Jin
Jin-Man
JM
Cho
Jeong-Hwan
JH
Park
Chong-Jin
CJ
Kim
D018806:APACHE; D000368:Aged; D000369:Aged, 80 and over; D002637:Chest Pain / Q000209:etiology; D004452:Echocardiography; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D054549:Takotsubo Cardiomyopathy / Q000175:diagnosis* / Q000401:mortality; D016277:Ventricular Function, Left