title: Mortality in takotsubo syndrome is similar to mortality in myocardial infarction - A report from the SWEDEHEART registry.
abstract: BACKGROUND
  Takotsubo syndrome is an acute cardiovascular condition that predominantly affects women. In this study, we compared patients with takotsubo syndrome and those with acute myocardial infarction with respect to patient characteristics, angiographic findings, and short- and long-term mortality.
  
  
  METHODS
  From the Swedish Coronary Angiography and Angioplasty Registry (SCAAR) and the Register of Information and Knowledge about Swedish Heart Intensive Care Admissions (RIKS-HIA), we obtained and merged data on patients undergoing coronary angiography in Västra Götaland County in western Sweden between January 2005 and May 2013. Short- and long-term mortality in patients with takotsubo (n=302) and patients with ST-elevation myocardial infarction (STEMI, n=6595) and non-ST-elevation myocardial infarction (NSTEMI, n=8207) were compared by modeling unadjusted and propensity score-adjusted logistic and Cox proportional-hazards regression.
  
  
  RESULTS
  The proportion of the patients diagnosed with takotsubo increased from 0.16% in 2005 to 2.2% in 2012 (P<0.05); 14% of these patients also had significant coronary artery disease. Cardiogenic shock developed more frequently in patients with takotsubo than NSTEMI (adjusted OR 3.08, 95% CI 1.80-5.28, P<0.001). Thirty-day mortality was 4.1% and was comparable to STEMI and NSTEMI. The long-term risk of dying from takotsubo (median follow-up 25 months) was also comparable to NSTEMI (adjusted HR 1.01, 95% CI 0.70-1.46, P=0.955) STEMI (adjusted HR 0.83, 95% CI 0.57-1.20, P=0.328).
  
  
  CONCLUSIONS
  The proportion of acute coronary syndromes attributed to takotsubo syndrome in Western Sweden has increased over the last decade. The prognosis of takotsubo syndrome is poor, with similar early and late mortality as STEMI and NSTEMI.
authors.affiliation: Department of Cardiology, Sahlgrenska University Hospital Gothenburg, Sweden. Electronic address: bjorn.redfors@wlab.gu.se.
authors.forename: Björn
authors.initials: B
authors.lastname: Redfors
authors.affiliation: Department of Cardiology, Sahlgrenska University Hospital Gothenburg, Sweden.
authors.forename: Ramtin
authors.initials: R
authors.lastname: Vedad
authors.affiliation: Department of Cardiology, Sahlgrenska University Hospital Gothenburg, Sweden.
authors.forename: Oskar
authors.initials: O
authors.lastname: Angerås
authors.affiliation: Department of Cardiology, Sahlgrenska University Hospital Gothenburg, Sweden.
authors.forename: Truls
authors.initials: T
authors.lastname: Råmunddal
authors.affiliation: Department of Cardiology, Sahlgrenska University Hospital Gothenburg, Sweden.
authors.forename: Petur
authors.initials: P
authors.lastname: Petursson
authors.affiliation: Department of Cardiology, Sahlgrenska University Hospital Gothenburg, Sweden.
authors.forename: Inger
authors.initials: I
authors.lastname: Haraldsson
authors.affiliation: Department of Cardiology, Sahlgrenska University Hospital Gothenburg, Sweden.
authors.forename: Anwar
authors.initials: A
authors.lastname: Ali
authors.affiliation: Department of Cardiology, Sahlgrenska University Hospital Gothenburg, Sweden.
authors.forename: Christian
authors.initials: C
authors.lastname: Dworeck
authors.affiliation: Department of Cardiology, Sahlgrenska University Hospital Gothenburg, Sweden.
authors.forename: Jacob
authors.initials: J
authors.lastname: Odenstedt
authors.affiliation: Department of Cardiology, Sahlgrenska University Hospital Gothenburg, Sweden.
authors.forename: Dan
authors.initials: D
authors.lastname: Ioaness
authors.affiliation: Department of Cardiology, Sahlgrenska University Hospital Gothenburg, Sweden.
authors.forename: Berglin
authors.initials: B
authors.lastname: Libungan
authors.affiliation: Department of Cardiology, Sahlgrenska University Hospital Gothenburg, Sweden.
authors.forename: Yangzhen
authors.initials: Y
authors.lastname: Shao
authors.affiliation: Department of Cardiology, Sahlgrenska University Hospital Gothenburg, Sweden.
authors.forename: Per
authors.initials: P
authors.lastname: Albertsson
authors.affiliation: Columbia University Medical Center New York, NY, USA; The Cardiovascular Research Foundation New York, NY, USA.
authors.forename: Gregg W
authors.initials: GW
authors.lastname: Stone
authors.affiliation: Department of Cardiology, Sahlgrenska University Hospital Gothenburg, Sweden.
authors.forename: Elmir
authors.initials: E
authors.lastname: Omerovic
mesh_terms: D000368:Aged; D002423:Cause of Death / Q000639:trends; D017023:Coronary Angiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000175:diagnosis / Q000401:mortality*; D011379:Prognosis; D016016:Proportional Hazards Models; D012042:Registries; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D013548:Sweden / Q000453:epidemiology; D054549:Takotsubo Cardiomyopathy / Q000175:diagnosis / Q000401:mortality*; D013997:Time Factors
keywords: Non-ST-elevation myocardial infarction; Percutaneous coronary intervention; ST-elevation myocardial infarction; Swedish Coronary Angiography and Angioplasty Registry; Takotsubo syndrome; Unstable angina pectoris