Abstract 2972: Recurrence Rate and Long Term Prognosis of The Apical Ballooning Syndrome
Background: The apical ballooning syndrome (ABS) is a recently described acute cardiac syndrome. Our Objective was to assess the long term prognosis of patients with ABS.
Methods and Results: We retrospectively identified 100 consecutive patients with confirmed diagnosis of ABS by angiography. Patients were grouped according to presence of identifiable precipitating events- group 1, 26 patients with an acute emotional stressor; group 2, 30 patients with an acute physical stressor; and group 3, 44 patients with no identified precipitating events. Patients were followed for recurrences of the ABS and mortality. Over a mean follow up time of 4.4 ± 4.6 years, 31 patients continued to have episodes of chest pain and 10 patients had recurrence of ABS for a recurrence rate of 11.4% over the first 4 years. There was no difference in the recurrence rate between the 3 groups. Over a mean follow-up time of 4.7 ± 4.8 years, 17 patients died. Patients in group 2 had worse survival compared to group 1 (Hazard ratio for mortality [HR], 14.0; p = 0.010), to group 3 (HR, 4.60; p = 0.015) and to a matched population (HR, 3.21; p < 0.001). The increased mortality was secondary to non-cardiac causes and secondary to the underlying general health of the patients. There was no statistical difference in the mortality of group 1, group 3 and a matched standardized population.
Conclusion: Patients with ABS experienced a recurrence rate of about 11.4% over four years following initial presentation. Recurrence of chest pain is common. Survival is largely dependent on the underlying medical condition of the patient. Patients with an identifiable physical stressor have significantly worse survival compared to patients with no precipitating physical stressor and to age- and sex-matched controls.