title: Characterization of predictors of in-hospital cardiac complications of takotsubo cardiomyopathy: multi-center registry from Tokyo CCU Network.
abstract: BACKGROUND
  Takotsubo cardiomyopathy (TC) is an acute cardiac syndrome characterized by transient left ventricular dysfunction and relatively good prognosis after discharge. However, cardiac complications during hospitalization remain to be fully determined. We attempted to determine features characterizing patients with adverse clinical outcome by comparing those with cardiac complication and without cardiac complication during hospitalization.
  
  
  RESULTS
  We investigated 107 patients with TC from the Tokyo CCU Network database, comprising 67 cardiovascular centers in the metropolitan area during January 1 to December 31, 2010. Cardiac complications were defined as cardiac death, pump failure (Killip grade≥II), sustained ventricular tachycardia or fibrillation (SVT/VF), and advanced atrioventricular block (AVB). Cardiac complications were observed in 41 patients (37 pump failure complicated by 3 cardiac deaths and 2 SVT/VF and 2 AVB without pump failure), and there was no cardiac complication in the remaining 66 patients. There was no difference in age, peak creatinine kinase level, C-reactive protein level and ST elevation on electrocardiogram. Multiple logistic regression analysis showed that white blood cell count (p=0.039) and brain natriuretic peptide (p=0.001) were independent predictors of in-hospital adverse cardiac complications.
  
  
  CONCLUSIONS
  Cardiac complications are relatively high in patients with TC during hospitalization. High white blood cell count and brain natriuretic peptide level are associated with poor clinical outcome in patients with TC.
authors.affiliation: Sakakibara Heart Institute, Fuchu, Japan.
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Murakami
authors.affiliation: Sakakibara Heart Institute, Fuchu, Japan. Electronic address: tyoshi@shi.heart.or.jp.
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Yoshikawa
authors.affiliation: Keio University School of Medicine, Japan.
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Maekawa
authors.affiliation: Tokyo Metropolitan Tama Medical Center, Japan.
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Ueda
authors.affiliation: Tokyo Metropolitan Tama Medical Center, Japan.
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Isogai
authors.affiliation: Musashino Red Cross Hospital, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Konishi
authors.affiliation: Kyorin University School of Medicine, Japan.
authors.forename: Konomi
authors.initials: K
authors.lastname: Sakata
authors.affiliation: Nihon University Surugadai Hospital, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Nagao
authors.affiliation: Nippon Medical School, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Yamamoto
authors.affiliation: Sakakibara Heart Institute, Fuchu, Japan.
authors.forename: Morimasa
authors.initials: M
authors.lastname: Takayama
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D054537:Atrioventricular Block / Q000453:epidemiology / Q000209:etiology; D015415:Biomarkers / Q000097:blood; D003325:Coronary Care Units / Q000706:statistics & numerical data*; D016757:Death, Sudden, Cardiac / Q000453:epidemiology / Q000209:etiology; D005260:Female; D005544:Forecasting; D006333:Heart Failure / Q000453:epidemiology / Q000209:etiology; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D011379:Prognosis; D012042:Registries / Q000706:statistics & numerical data*; D017180:Tachycardia, Ventricular / Q000453:epidemiology / Q000209:etiology; D054549:Takotsubo Cardiomyopathy / Q000150:complications / Q000175:diagnosis; D013997:Time Factors; D014041:Tokyo / Q000453:epidemiology; D014693:Ventricular Fibrillation / Q000453:epidemiology / Q000209:etiology
chemical_list: D015415:Biomarkers; D020097:Natriuretic Peptide, Brain
keywords: Arrhythmia; Heart failure; Inflammation; Mortality; Takotsubo cardiomyopathy