Table I.
Comparison of 3 groups of patients with takotsubo syndrome (n = 80)
| Parameter | Group I BMI < 18.5 kg/m2 n = 6 (SD) N (%) | Group II 18.5 ≥ BMI < 25 kg/m2 n = 28 (SD) N (%) | Group III BMI ≥ 25 kg/m2 n = 46 (SD) N (%) | P-value GI vs. GII | P-value GI vs. GIII | P-value GII vs. GIII |
|---|---|---|---|---|---|---|
| Clinical and demographic characteristics: | ||||||
| Age [years] | 76.3 (5.7) | 67.6 (15.8) | 67.0 (12.1) | 0.0309 | 0.0081 | 0.959 |
| Female sex (%) | 5 (83.3) | 26 (92.9) | 43 (93.5) | 0.451 | 0.377 | 0.920 |
| Body mass index (BMI) [kg/m2] | 17.2 | 22.4 | 29.1 | – | – | – |
| History of malignancy (%) | 2 (33.3) | 2 (7.1) | 0 (0.0) | 0.071 | < 0.001 | 0.066 |
| History of hypertension (%) | 3 (50.0) | 15 (53.6) | 32 (69.6) | 0.872 | 0.335 | 0.165 |
| Hyperlipidemia (%) | 1 (16.7) | 11 (39.3) | 19 (41.3) | 0.293 | 0.244 | 0.865 |
| Smoking (%) | 2 (33.3) | 5 (17.9) | 18 (23.9) | 0.397 | 0.616 | 0.543 |
| Family history of coronary artery disease (%) | 0 (0.0) | 3 (10.7) | 12 (26.1) | 0.401 | 0.153 | 0.110 |
| Diabetes mellitus (%) | 1 (16.7) | 0 (0.0) | 11 (23.9) | 0.028 | 0.693 | 0.005 |
| Anxiety/depression (%) | 2 (33.3) | 2 (7.1) | 4 (8.7) | 0.076 | 0.071 | 0.811 |
| Thyroid disorders (%) | 1 (16.7) | 6 (21.4) | 13 (28.3) | 0.796 | 0.547 | 0.510 |
| Chronic kidney disease (%) | 2 (33.3) | 2 (7.1) | 6 (13.0) | 0.076 | 0.207 | 0.404 |
| COPD (%) | 3 (50.0) | 4 (14.3) | 3 (6.5) | 0.049 | 0.0017 | 0.267 |
| Diagnostic tests (echocardiography, coronarography, ECG): | ||||||
| Left ventricular ejection fraction on admission (%) | 38.2 (6.0) | 38.9 (7.1) | 40.1 (10.5) | 0.808 | 0.528 | 0.560 |
| No atherosclerotic changes in coronary arteries* (%) | 2 (33.3) | 13 (46.4) | 20 (43.5) | 0.557 | 0.634 | 0.807 |
| Insignificant stenoses**(%) | 4 (66.7) | 15 (53.6) | 26 (56.5) | 0.557 | 0.634 | 0.807 |
| ECG – ST elevation (%) | 6 (100.0) | 19 (67.9) | 30 (65.2) | 0.105 | 0.082 | 0.811 |
| QT on admission [ms] | 350.0 (22.7) | 410.9 (55.8) | 412.3 (46.8) | 0.0003 | 0.0002 | 0.912 |
| QTc on admission [ms] | 452.3 (16.7) | 464.7 (37.7) | 470.6 (41.2) | 0.225 | 0.063 | 0.530 |
| QT after a few days*** [ms] | 444.0 (44.0) | 457.0 (53.7) | 440.9 (57.6) | 0.546 | 0.882 | 0.228 |
| QTc after a few days*** [ms] | 496.7 (18.5) | 460.5 (130.3) | 476.8 (44.8) | 0.170 | 0.067 | 0.527 |
| Laboratory parameters: | ||||||
| Haemoglobin [mg/dl] | 14.2 (3.1) | 12.8 (1.2) | 13.4 (1.6) | 0.202 | 0.228 | 0.038 |
| Erythrocytes [× 106/µl] | 4.9 (1.2) | 4.3 (0.5) | 4.5 (0.6) | 0.311 | 0.530 | 0.066 |
| Haematocrit (%) | 41.9 (9.2) | 38.2 (3.8) | 39.4 (6.9) | 0.370 | 0.537 | 0.338 |
| Leukocytes [× 103/µl] | 12.1 (5.8) | 7.9 (2.3) | 10.0 (3.9) | 0.1429 | 0.4289 | 0.0051 |
| Creatinine [mg/dl] | 0.91 (0.29) | 0.85 (0.28) | 0.92 (0.42) | 0.657 | 0.942 | 0.393 |
| eGFR MDRD [m/min/1.72 m2] | 70.9 (23.8) | 75.8 (24.2) | 72.6 (25.7) | 0.662 | 0.875 | 0.592 |
| CK [IU/l] | 156.5 (97.9) | 358.3 (450.5) | 580.6 (1263.4) | 0.026 | 0.027 | 0.282 |
| Troponin (significant increase)**** (%) | 3 (50.0) | 27 (96.4) | 44 (95.7) | 0.0013 | 0.0003 | 0.882 |
| Troponin – mean concentration [ng/ml] | 1.09 (0.99) | 6.16 (17.98) | 5.15 (8.35) | 0.150 | 0.0029 | 0.781 |
| Total cholesterol [mg/dl] | 165.2 (30.9) | 189.6 (38.1) | 182.4 (45.4) | 0.131 | 0.262 | 0.466 |
| LDL [mg/dl] | 96.3 (18.8) | 115.9 (33.2) | 113.1 (43.1) | 0.071 | 0.115 | 0.754 |
| HDL [mg/dl] | 51.6 (17.8) | 56.7 (17.0) | 49.3 (17.3) | 0.541 | 0.775 | 0.076 |
| Triglycerides [mg/dl] | 70.1 (22.5) | 88.9 (35.6) | 106.6 (60.8) | 0.125 | 0.011 | 0.120 |
| CRP [mg/l] | 11.74 (7.7) | 26.5 (30.7) | 38.7 (65.8) | 0.032 | 0.0109 | 0.284 |
| Clinical course and mortality: | ||||||
| Retrosternal chest pain (%) | 5 (83.3) | 21 (75.0) | 42 (91.3) | 0.663 | 0.532 | 0.055 |
| Dyspnoea (%) | 1 (16.7) | 4 (14.3) | 3 (6.5) | 0.880 | 0.378 | 0.267 |
| Cardiac arrest, pulmonary oedema, cardiogenic shock (%) | 0 (0.0) | 5 (17.9) | 6 (13.0) | 0.261 | 0.347 | 0.568 |
| Cardiac rupture (%) | 0 (0.0) | 1 (3.6) | 1 (2.2) | 0.638 | 0.715 | 0.718 |
| Pneumonia (%) | 2 (33.3) | 3 (10.7) | 10 (21.7) | 0.155 | 0.488 | 0.268 |
| Rhythm disturbances | 1 (16.7) | 2 (7.1) | 3 (6.5) | 0.453 | 0.378 | 0.917 |
| In-hospital mortality (%) | 0 (0.0) | 1 (3.6) | 1 (2.2) | 0.638 | 0.715 | 0.718 |
| 1-year mortality (%) | 3 (50.0) | 3 (10.7) | 3 (6.5) | 0.021 | 0.0017 | 0.522 |
| 3-year mortality (%) | 5 (83.3) | 5 (17.9) | 5 (10.9) | < 0.0001 | < 0.0001 | 0.393 |
| 5-year mortality (%) | 6 (100.0) | 7 (25.0) | 7 (15.2) | 0.0006 | < 0.0001 | 0.2964 |
*
No atherosclerotic changes in coronary arteries – coronary arteries without any atherosclerotic lesions.
**
Iinsignificant stenoses – presence of atherosclerotic lesions in the coronary arteries, which do not cause haemodynamically significant stenoses.
***
Typical for takotsubo prolongation of QT and QTC is observed a few (3–5) days from the onset of symptoms takotsubo.
****
Troponin (significant increase) – troponin value above the upper limit of normal.