title: In-hospital and long-term mortality in Takotsubo cardiomyopathy: a community hospital experience.
abstract: BACKGROUND
  Takotsubo cardiomyopathy (TTC) is characterized by reversible left ventricular dysfunction, frequently precipitated by a stressful event. Despite the favorable course and good long-term prognosis, a variety of complications may occur in the acute phase of the disease. The aim of this study was to evaluate the in-hospital and long-term outcomes of a cohort of TTC patients.
  
  
  METHODS
  Fifty-five patients (mean age 68.1±12 years) were prospectively followed for a mean of 69.6±32.2 months (64,635 days). In-hospital (death, heart failure, arrhythmias) and long-term events (death and recurrences) were recorded.
  
  
  RESULTS
  Patients were predominantly women (87.3%) who experienced a recent stressful event (emotional or physical) and were admitted to hospital for chest pain. Eleven patients (20%) had a diagnosis of depressive disorder, and arterial hypertension was the most frequent cardiovascular risk factor. The ECG revealed ST-segment elevation in 43.6% of patients. At angiography, seven cases (12.7%) had at least one significant (≥50%) coronary artery stenosis and four patients (7.3%) had myocardial bridging of the left anterior descending artery. During hospitalization, three patients died (one from cardiac causes) and cardiovascular complications occurred in 12 patients. During follow-up, five patients died (none from cardiac causes), six patients had recurrences within the first year. Two patients had two recurrences: one after 114 days, triggered by an asthma attack as the first event, and the other after 1,850 days.
  
  
  CONCLUSIONS
  In TTC patients, in-hospital and long-term mortality is primarily due to non-cardiovascular causes. Recurrences are not infrequent and coronary artery disease is not an uncommon finding.
authors.affiliation: Cardiology and Emergency Department, San Antonio Hospital, Udine, Italy; olgavriz@yahoo.com.
authors.forename: Olga
authors.initials: O
authors.lastname: Vriz
authors.affiliation: Cardiology and Emergency Department, San Antonio Hospital, Udine, Italy.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Brosolo
authors.affiliation: Cardiology and Emergency Department, San Antonio Hospital, Udine, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Martina
authors.affiliation: Cardiology and Emergency Department, San Antonio Hospital, Udine, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Pertoldi
authors.affiliation: Department of Cardiology "Cava de' Tirreni and Amalfi Coast" Hospital, University of Salerno, Fisciano, Italy.
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Citro
authors.affiliation: Cardiology and Emergency Department, San Antonio Hospital, Udine, Italy.
authors.forename: Lucio
authors.initials: L
authors.lastname: Mos
authors.affiliation: Department of Cardiology "Cava de' Tirreni and Amalfi Coast" Hospital, University of Salerno, Fisciano, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Ferrara
authors.affiliation: Department of Cardiology "Cava de' Tirreni and Amalfi Coast" Hospital, University of Salerno, Fisciano, Italy.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Bossone
keywords: Takotsubo cardiomyopathy; coronary artery disease; follow-up study; recurrence