title: Renal impairment and outcome in patients with takotsubo cardiomyopathy.
abstract: OBJECTIVE
  The objectives were to ascertain the prevalence of renal impairment among patients with a takotsubo cardiomyopathy (TTC) episode and whether clinical outcomes are related to renal function.
  
  
  METHODS
  A total of 108 consecutive subjects with TTC were enrolled in a multicenter registry and followed for a mean period of 429 days. Renal function was evaluated during hospitalization in terms of acute kidney injury/failure and estimated glomerular filtration rate (eGFR). Incidence of death, rehospitalization, and recurrence of TTC during follow-up was recorded.
  
  
  RESULTS
  Raised creatinine levels can be found during hospitalizations for TTC episodes (analysis of variance P<.001). Incidence of acute kidney injury was 10%; that of acute kidney failure was 1%. Admission eGFR levels were proportional to the duration of hospitalization (r = -0.28, P<.01). Estimated GFR nadir values were related to adverse events at follow-up (log-rank P<.001). The hazard ratio of adverse events at follow-up in subjects with severe renal impairment (nadir eGFR <30 mL/[min 1.73 m(2)]) vs those with eGFR >60 mL/(min 1.73 m(2)) was 1.817 (95% confidence interval, 1.097-3.009; P<.05).
  
  
  CONCLUSIONS
  Raised creatinine levels and impaired renal function may be found in patients with TTC. Lower eGFR values during hospitalization are associated with longer hospitalizations and higher rates of adverse events at follow-up. Renal function during a TTC episode should be carefully evaluated.
authors.affiliation: University of Foggia, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Santoro
authors.affiliation: University of Foggia, Italy.
authors.forename: Armando
authors.initials: A
authors.lastname: Ferraretti
authors.affiliation: University of Foggia, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Ieva
authors.affiliation: University of Foggia, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Musaico
authors.affiliation: University of Foggia, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Fanelli
authors.affiliation: University of Foggia, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Tarantino
authors.affiliation: University of Foggia, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Scarcia
authors.affiliation: San Paolo Hospital, Bari, Italy.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Caldarola
authors.affiliation: University of Foggia, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Di Biase
authors.affiliation: University of Foggia, Italy. Electronic address: natale.brunetti@unifg.it.
authors.forename: Natale Daniele
authors.initials: ND
authors.lastname: Brunetti
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood; D001806:Blood Urea Nitrogen; D003404:Creatinine / Q000097:blood; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D015337:Multicenter Studies as Topic; D011379:Prognosis; D011446:Prospective Studies; D012042:Registries; D051437:Renal Insufficiency / Q000209:etiology*; D012720:Severity of Illness Index; D054549:Takotsubo Cardiomyopathy / Q000150:complications* / Q000175:diagnosis; D019210:Troponin I / Q000097:blood
chemical_list: D015415:Biomarkers; D019210:Troponin I; D003404:Creatinine