Table 1.
Characteristics of takotsubo patients
| Characteristic | Acute pulmonary trigger | Chronic lung disease | No lung disease | P value |
|---|---|---|---|---|
| N = 123 | N = 194 | N = 1353 | ||
| Demographics | ||||
| Female sex—no./total no. (%) | 103/123 (83.7) | 165/194 (85.1) | 1230/1353 (90.9) | 0.003 |
| Age (years) | 67.3 ± 11.5 (N = 123) | 66.6 ± 11.5 (N = 194) | 66.4 ± 13.3 (N = 1353) | 0.76 |
| Triggers—no./total no. (%) | ||||
| Physical | 123/123 (100.0) | 67/194 (34.5) | 407/1353 (30.1) | <0.001 |
| Emotional | 0/123 (0.0) | 40/194 (20.6) | 432/1353 (31.9) | <0.001 |
| No evident trigger | 0/123 (0.0) | 62/194 (32.0) | 410/1353 (30.3) | <0.001 |
| Takotsubo type—no./total no. (%) | ||||
| Typical | 92/123 (74.8) | 157/194 (80.9) | 1110/1353 (82.0) | 0.14 |
| Symptoms on admission—no./total no. (%) | ||||
| Chest pain | 56/107 (52.3) | 127/177 (71.8) | 1002/1274 (78.6) | <0.001 |
| Dyspnoea | 100/115 (87.0) | 110/177 (62.1) | 523/1265 (41.3) | <0.001 |
| Cardiac biomarkers—median (IQR) | ||||
| Troponin on admission—factor increase in ULN* | 8.67 (2.07–24.86) N = 101 | 4.90 (1.80–19.90) N = 157 | 8.00 (2.36–23.43) N = 1107 | 0.18 |
| Creatine kinase on admission—factor increase in ULN | 0.71 (0.39–1.13) N = 75 | 0.75 (0.46–1.44) N = 126 | 0.87 (0.54–1.51) N = 959 | 0.016 |
| BNP on admission—factor increase in ULN † | 4.73 (1.68–18.20) N = 40 | 6.29 (2.38–16.24) N = 66 | 6.64 (2.16–16.16) N = 324 | 0.74 |
| Inflammatory markers—median (IQR) | ||||
| CRP on admission (mg/L) | 5.80 (1.65–21.13) N = 72 | 4.00 (1.40–9.60) N = 111 | 3.80 (1.40–11.30) N = 911 | 0.33 |
| WBC on admission (103/μL) | 11.58 (8.68–15.78) N = 106 | 10.04 (8.00–12.88) N = 160 | 9.60 (7.30–12.30) N = 1150 | <0.001 |
| ECG on admission—no./total no. (%) | ||||
| ST‐segment elevation | 40/106 (37.7) | 74/172 (43.0) | 548/1238 (44.3) | 0.42 |
| T‐wave inversion | 47/106 (44.3) | 69/172 (40.1) | 509/1238 (41.1) | 0.77 |
| QTc (ms) | 453.1 ± 50.5 (N = 83) | 460.4 ± 52.9 (N = 140) | 457.4 ± 49.3 (N = 882) | 0.58 |
| Haemodynamics—mean ± SD (N) | ||||
| Heart rate (beats per minute) | 98.3 ± 22.9 (N = 99) | 91.4 ± 20.6 (N = 160) | 86.1 ± 21.7 (N = 1137) | <0.001 |
| Systolic blood pressure (mmHg) | 129.3 ± 27.1 (N = 96) | 132.2 ± 31.1 (N = 165) | 130.8 ± 28.7 (N = 1139) | 0.73 |
| Diastolic blood pressure (mm Hg) | 77.2 ± 19.0 (N = 94) | 76.4 ± 17.0 (N = 163) | 76.8 ± 16.9 (N = 1122) | 0.92 |
| Left ventricular ejection fraction (%) ‡ | 38.1 ± 12.1 (N = 110) | 39.8 ± 11.6 (N = 182) | 41.4 ± 11.7 (N = 1241) | 0.005 |
| Cardiovascular risk factors—no./total no. (%) | ||||
| Hypertension | 85/123 (69.1) | 129/193 (66.8) | 869/1343 (64.7) | 0.55 |
| Diabetes mellitus | 17/122 (13.9) | 32/193 (16.6) | 191/1348 (14.2) | 0.66 |
| Current smoking | 38/120 (31.7) | 68/190 (35.8) | 222/1309 (17.0) | <0.001 |
| Hypercholesterolemia | 42/122 (34.4) | 59/192 (30.7) | 420/1342 (31.3) | 0.76 |
| Cancer—no./total no. (%) | 16/118 (13.6) | 45/185 (24.3) | 199/1289 (15.4) | 0.007 |
| Respiratory tract | 5/118 (4.2) | 12/185 (6.5) | 22/1289 (1.7) | <0.001 |
| Medication at discharge—no. (%) | ||||
| ACE‐inhibitor or ARB | 82/109 (75.2) | 142/178 (79.8) | 952/1189 (80.1) | 0.49 |
| Beta‐blocker | 76/109 (69.7) | 124/178 (69.7) | 948/1189 (79.7) | 0.001 |
| Calcium‐channel antagonist | 13/109 (11.9) | 12/178 (6.7) | 101/1189 (8.5) | 0.31 |
| Statin | 54/109 (49.5) | 89/178 (50.0) | 616/1189 (51.8) | 0.83 |
| Aspirin | 71/109 (65.1) | 125/178 (70.2) | 794/1189 (66.8) | 0.60 |
| P2Y12 antagonist | 15/109 (13.8) | 24/178 (13.5) | 128/1189 (10.8) | 0.40 |
| Coumarin | 9/109 (8.3) | 8/178 (4.5) | 104/1189 (8.7) | 0.16 |
| Acute intensive care treatment—no./total no. (%) | 55/122 (45.1) | 48/193 (24.9) | 235/1349 (17.4) | <0.001 |
| Intra‐aortic balloon pump | 4/122 (3.3) | 4/193 (2.1) | 36/1349 (2.7) | 0.80 |
| Invasive or non‐invasive ventilation | 55/122 (45.1) | 41/193 (21.2) | 183/1349 (13.6) | <0.001 |
| Cardiopulmonary resuscitation | 12/122 (9.8) | 11/193 (5.7) | 117/1349 (8.7) | 0.32 |
| Catecholamine use | 29/122 (23.8) | 23/193 (11.9) | 147/1349 (10.9) | <0.001 |
| In‐hospital complications—no./total no. (%) | 26/122 (21.3) | 20/192 (10.4) | 148/1343 (11.0) | 0.003 |
| Cardiogenic shock | 21/122 (17.2) | 19/192 (9.9) | 123/1343 (9.2) | 0.017 |
| Death | 7/123 (5.7) | 3/194 (1.5) | 57/1353 (4.2) | 0.13 |
ACE, angiotensin‐converting enzyme; ARB, angiotensin receptor blocker; BNP, brain natriuretic peptide; CRP, C‐reactive protein; ECG, electrocardiogram; IQR, interquartile range;QTc, QT time corrected for heart rate; SD, standard deviation; ULN, upper limit of normal; WBC, white blood cell count.
*
Including upper limits of the normal range for troponin T, high‐sensitivity troponin T, and troponin I.
†
Including upper limits of the normal range for brain natriuretic peptide and the N‐terminal of prohormone brain natriuretic peptide.
‡
Data obtained during catheterization or echocardiography; if both results were available data from catheterization were used.