Table 2.
Comparison between TTS Patients with Preexisting and Newly Diagnosed AF
| Preexisting AF | Newly diagnosed AF | P value | |
|---|---|---|---|
| N=48 | N=35 | ||
| Demographics | |||
| Female sex, no./total no. (%) | 44/48 (91.7) | 30/35 (85.7) | 0.48 |
| Age, y | 76.8±9.2 (N=48) | 73.8±11.8 (N=35) | 0.20 |
| Takotsubo Type, no./total no. (%) | |||
| Apical | 42/48 (87.5) | 32/35 (91.4) | 0.7 |
| Triggers, no./total no. (%) | |||
| Physical trigger | 24/48 (50.0) | 17/35 (48.6) | 0.90 |
| Emotional trigger | 9/48 (18.8) | 8/35 (22.9) | 0.65 |
| Symptoms on admission, no./total no. (%) | |||
| Chest pain | 29/41 (70.7) | 21/32 (65.6) | 0.64 |
| Syncope | 1/46 (2.2) | 2/32 (6.3) | 0.57 |
| Cardiac biomarkers on admission, median (IQR) | |||
| Troponin, factor increase in ULN* | 11.50 (3.05–25.78) N=41 | 5.35 (1.03–16.93) N=32 | 0.17 |
| Creatine kinase, factor increase in ULN | 0.80 (0.47–1.69) N=32 | 0.89 (0.43–1.67) N=26 | 0.62 |
| BNP, factor increase in ULN† | 10.23 (2.32–25.52) N=15 | 10.08 (5.49–37.81) N=15 | 0.49 |
| Inflammatory markers on admission, median (IQR) | |||
| CRP, mg/L | 9.30 (1.40–47.28) N=36 | 3.99 (1.95–18.20) N=26 | 0.64 |
| WBC, 103/µL | 11.35 (10.08–15.70) N=39 | 9.95 (7.60–11.60) N=31 | 0.05 |
| ECG on admission, no./total no. (%) | |||
| ST‐segment elevation | 19/48 (39.6) | 18/35 (51.4) | 0.28 |
| T‐wave inversion | 18/48 (37.5) | 14/35 (40.0) | 0.82 |
| QTc, ms | 451.0±63.0 (N=36) | 454.5±70.4 (N=25) | 0.84 |
| Hemodynamics, mean±SD (N) | |||
| Heart rate, beats/min | 87.0±23.6 (N=39) | 103.4±15.9 (N=30) | 0.002 |
| Systolic blood pressure, mm Hg | 134.1±28.8 (N=38) | 125.4±30.6 (N=30) | 0.23 |
| Diastolic blood pressure, mm Hg | 79.6±18.3 (N=38) | 74.9±17.5 (N=30) | 0.29 |
| Left ventricular ejection fraction, %‡ | 37.6±10.9 (N=44) | 37.4±10.8 (N=32) | 0.93 |
| Left ventricular end‐diastolic pressure, mm Hg | 22.0±8.5 (N=30) | 20.5±7.1 (N=20) | 0.51 |
| Cardiovascular risk factors/history, no./total no. (%) | |||
| Hypertension | 41/47 (87.2) | 31/34 (91.2) | 0.73 |
| Diabetes mellitus | 14/47 (29.8) | 7/33 (21.2) | 0.39 |
| Current smoking | 7/45 (15.6) | 5/31 (16.1) | 0.95 |
| Hypercholesterolemia | 15/47 (31.9) | 9/33 (27.3) | 0.66 |
| Coexisting medical condition, no./total no. (%) | |||
| Coronary artery disease§ | 8/47 (17.0) | 10/33 (30.3) | 0.16 |
| Cancer (total) | 9/45 (20.0) | 4/30 (13.3) | 0.55 |
| COPD or asthma | 5/47 (10.6) | 4/30 (13.3) | 0.73 |
| Medication on admission, no./total no. (%) | |||
| ACE inhibitor or ARB | 21/41 (51.2) | 13/27 (48.1) | 0.80 |
| Beta‐blocker | 20/41 (48.8) | 14/27 (51.9) | 0.80 |
| Statin | 10/41 (24.4) | 5/27 (18.5) | 0.57 |
| Aspirin | 21/41 (51.2) | 12/26 (46.2) | 0.69 |
| Oral anticoagulants | 24/42 (57.1) | 1/32 (3.1) | <0.001 |
| Acute cardiac care, no./total no. (%) | |||
| Intra‐aortic balloon pump | 4/47 (8.5) | 2/35 (5.7) | >0.99 |
| Cardiopulmonary resuscitation | 10/47 (21.3) | 6/35 (17.1) | 0.64 |
| Invasive or noninvasive ventilation | 16/47 (34.0) | 7/35 (20.0) | 0.16 |
| Catecholamine use | 10/47 (21.3) | 8/35 (22.9) | 0.86 |
| In‐hospital complications, no./total no. (%) | |||
| Cardiogenic shock | 13/46 (28.3) | 5/35 (14.3) | 0.13 |
| Death | 9/48 (18.8) | 5/35 (14.3) | 0.59 |
| 5‐year outcome, no./total no. (%) | |||
| MACCE | 17/48 (35.4) | 11/35 (31.4) | 0.53 |
| Death | 15/48 (31.3) | 9/35 (25.7) | 0.48 |
ACE indicates angiotensin‐converting‐enzyme; AF, atrial fibrillation; ARB, angiotensin‐receptor blocker; BNP, brain natriuretic peptide; COPD, chronic obstructive pulmonary disease; CRP, c‐reactive protein; ECG, electrocardiogram; IQR, interquartile range; MACCE, major adverse cardiac and cerebrovascular events; QTc, QT interval corrected for heart rate; SD, standard deviation; TTS, takotsubo syndrome; ULN, upper limit of the normal; and 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.
Coexisting coronary artery disease during acute hospitalization.