Abstract 18427: Low Left Ventricular Ejection Fraction and β-blocker Use Before Admission is Associated With In-hospital Cardiac Complications in Patients With Takotsubo Cardiomyopathy
Introduction: The prognosis of patients with takotsubo cardiomyopathy (TC) is thought to be relatively favorable. However, serious cardiac complications during hospitalization occur in some patients. There is little information about risk factors associated with in-hospital cardiac complications in patients with TC.
Hypothesis: We assessed the hypothesis that severe left ventricular (LV) dysfunction is associated with in-hospital cardiac complications in patients with TC.
Methods: A total of 154 consecutive patients with TC based on Mayo criteria were enrolled. Coronary angiography and left ventriculography were performed in all patients and absence of obstructive coronary disease explaining the left ventricular contraction abnormality was confirmed. In-hospital cardiac complications were defined as cardiogenic shock, pulmonary edema, sustained ventricular tachycardia or ventricular fibrillation, complete atrioventricular block, thromboembolism, cardiac rupture, and cardiac death. Multivariate logistic regression analysis was performed to predict in-hospital cardiac complications.
Results: In-hospital cardiac complications were observed in 61 patients (40%). There were 25 patients with cardiogenic shock (16%) and 44 patients with pulmonary edema (29%). Sustained ventricular tachycardia or ventricular fibrillation, complete atrioventricular block, and thromboembolism were noted in 10 (7%), 4 (3%) and 4 patients (3%), respectively. Four cardiac deaths (3%) were observed. Of these, one patient died of cardiac rupture. Multivariate logistic regression analysis identified systolic blood pressure (odds ratio=0.97, 95% CI=0.95-0.98, p <0.01), LV ejection fraction (odds ratio=0.95, 95% CI=0.91-0.98, p <0.01), and β-blocker use before admission (odds ratio=8.72, 95%CI=1.00-194.2, p =0.049) as independent predictors of cardiac complications during hospitalization.
Conclusion: Low systolic blood pressure and low LV ejection fraction are independent predictors of in-hospital cardiac complications in patients with TC. Furthermore, β-blocker use before admission is associated with worse outcomes during hospitalization.
Author Disclosures: K. Kato: None. Y. Saito: None. Y. Sakai: None. I. Ishibashi: None. M. Yamamoto: None. T. Himi: None. Y. Fujimoto: None. Y. Kobayashi: None.
- © 2015 by American Heart Association, Inc.