Abstract：
Takotsubo syndrome (TTS) is an acute cardiovascular disease with clinical manifestations similar to those of acute myocardial infarction (AMI), and TTS sometimes occurs just after catastrophes. Large-scale studies of TTS in Japan are scarce, so we examined data over 9 years from Tokyo metropolitan acute cardiovascular care hospital network registry.
A total of 1626 patients were diagnosed with TTS between 2010 and 2018 at Tokyo Cardiovascular Care Unit Network facilities, and data from all these patients were analyzed. We investigated annual and monthly captured incidence of TTS, temporal trend of the captured incidence proportion of TTS versus AMI, the occurrence of TTS on the day of the great earthquake, and we elucidated the prognostic factors for in-hospital death.
The annual incidence proportion of TTS versus AMI increased from 2.3 % to 4.5 % (p < 0.001) over 9 years. The mean TTS patient age was 74.4 years: the peak incidence of TTS was at 80 to 84 years of age for both male and female; females accounted for 78.5 % of patients. The monthly variation of the incidence of TTS was found (p = 0.009). In 2011, a total of 137 cases of TTS occurred, with as many as 6 occurring on March 11, the day of the Great East Japan Earthquake. There was a definable trigger for TTS in 64 % (physical: 36 %; emotional: 27 %; others: 2 %). All-cause in-hospital mortality was 5.3 % and was higher in males than in females (10.3 % vs 3.9 %; p < 0.001). Non-cardiac causes accounted for 62 % of in-hospital mortality. Factors at presentation that were associated with in-hospital all-cause mortality were male sex, low body mass index, and a high C-reactive protein level.
This study elucidated the clinical features, in-hospital outcomes, and their attributed factors in patients with TTS in real-world clinical practice in Japan.
A total of 1626 patients were diagnosed with TTS between 2010 and 2018 at Tokyo Cardiovascular Care Unit Network facilities, and data from all these patients were analyzed. We investigated annual and monthly captured incidence of TTS, temporal trend of the captured incidence proportion of TTS versus AMI, the occurrence of TTS on the day of the great earthquake, and we elucidated the prognostic factors for in-hospital death.
The annual incidence proportion of TTS versus AMI increased from 2.3 % to 4.5 % (p < 0.001) over 9 years. The mean TTS patient age was 74.4 years: the peak incidence of TTS was at 80 to 84 years of age for both male and female; females accounted for 78.5 % of patients. The monthly variation of the incidence of TTS was found (p = 0.009). In 2011, a total of 137 cases of TTS occurred, with as many as 6 occurring on March 11, the day of the Great East Japan Earthquake. There was a definable trigger for TTS in 64 % (physical: 36 %; emotional: 27 %; others: 2 %). All-cause in-hospital mortality was 5.3 % and was higher in males than in females (10.3 % vs 3.9 %; p < 0.001). Non-cardiac causes accounted for 62 % of in-hospital mortality. Factors at presentation that were associated with in-hospital all-cause mortality were male sex, low body mass index, and a high C-reactive protein level.
This study elucidated the clinical features, in-hospital outcomes, and their attributed factors in patients with TTS in real-world clinical practice in Japan.
摘要：
背景：Takotsubo综合征（TTS）是一种急性心血管疾病，其临床表现与急性心肌梗死（AMI）相似，TTS有时发生在灾难之后。日本对TTS的大规模研究很少，因此，我们检查了东京都急性心血管护理医院网络注册的9年数据。
方法：2010年至2018年期间，共有1626名患者在东京心血管监护病房网络设施被诊断为TTS，并对所有这些患者的数据进行了分析。我们调查了每年和每月捕获的TTS发生率，TTS与AMI的捕获发病率比例的时间趋势，大地震当天TTS的发生，我们阐明了院内死亡的预后因素。
结果：在9年中，TTS与AMI的年发病率从2.3％增加到4.5％（p<0.001）。TTS患者的平均年龄为74.4岁：男性和女性的TTS发生率最高为80至84岁；女性占患者的78.5％。发现TTS发生率的每月变化（p=0.009）。2011年共发生137例TTS,3月11日发生了多达6次的东日本大地震。在64％（身体：36％;情感：27％;其他：2％）的TTS有明确的触发因素。全因住院死亡率为5.3%，男性高于女性（10.3%vs3.9%；p<0.001）。非心脏原因占院内死亡率的62％。与住院全因死亡率相关的因素是男性，低体重指数，和高C反应蛋白水平。
结论：这项研究阐明了临床特征，住院结果，以及日本现实临床实践中TTS患者的归因因素。
方法：2010年至2018年期间，共有1626名患者在东京心血管监护病房网络设施被诊断为TTS，并对所有这些患者的数据进行了分析。我们调查了每年和每月捕获的TTS发生率，TTS与AMI的捕获发病率比例的时间趋势，大地震当天TTS的发生，我们阐明了院内死亡的预后因素。
结果：在9年中，TTS与AMI的年发病率从2.3％增加到4.5％（p<0.001）。TTS患者的平均年龄为74.4岁：男性和女性的TTS发生率最高为80至84岁；女性占患者的78.5％。发现TTS发生率的每月变化（p=0.009）。2011年共发生137例TTS,3月11日发生了多达6次的东日本大地震。在64％（身体：36％;情感：27％;其他：2％）的TTS有明确的触发因素。全因住院死亡率为5.3%，男性高于女性（10.3%vs3.9%；p<0.001）。非心脏原因占院内死亡率的62％。与住院全因死亡率相关的因素是男性，低体重指数，和高C反应蛋白水平。
结论：这项研究阐明了临床特征，住院结果，以及日本现实临床实践中TTS患者的归因因素。
