Abstract 15083: Differences in Clinical Features, Presentation, Management and Outcomes of Elderly Patients with Tako-Tsubo Cardiomyopathy
Purpose: To describe the clinical characteristics of elderly patients with Tako-tsubo cardiomyopathy (TTC).
Methods: One hundred ninety consecutive TTC patients (mean age 66 ± 11 years range 22–86;175 female), enrolled between January 2002 and March 2010 (according to the Majo Clinic diagnostic criteria for TTC) in the Tako-tsubo Italian Network (TIN), were categorized into two age groups: “group A” <65 years (78 pts; mean age 55 ± 8 yy) and “group B” ≥ 65 (112 pts; mean age 74 ± 6 yy). Clinical presentation, electrocardiographic, echocardiographic, angiographic and laboratory findings of the two cohorts were compared. In- hospital adverse hard events (acute heart failure, cardiogenic shock, life-threathining arrhythmia and all-causes mortality) were registered.
Results: There were no significant differences between the two groups regarding presenting symptoms (chest pain 85% vs 78% p = ns; dyspnea 10% vs 12% p = ns; other symptoms 5% vs 10% p; = ns). Apical form (84% vs 94% p = 0,032) and ST elevation at admission (38 % vs 58% p = 0,008) were prevalent in group B. Trigger events were reported only in 66% of elderly patients compared with 81% of the younger cohort (p= 0.027). Despite no differences (38±6 vs 37±6; p = ns) at hospital admission, left ventricular ejection fraction (LVEF) was lower at discharge in elderly (55±9 vs 52±18; p = 0.034). In the overall population in-hospital mortality was low (5/190;2,8%), higher in the elderly cohort (4/5). In-hospital hard events were more frequent in elderly pts (15,5% vs 28,7% p = 0,039). Elderly pts were also characterized by prolonged in-hospital stay (median 5 vs 7 days; p = 0,038). At multivariate analysis age (HR: 0,325; p = 0,017) and LVEF (HR: 0,844; p = <0,001 ) at admission were the only independent predictors of hard events.
Conclusions: Elderly TTC patients have a distinct clinical profile with a delayed recovery of LVEF and more frequent in-hospital complications.
- © 2010 by American Heart Association, Inc.