PDF(Pubmed)
Abstract：
OBJECTIVE: This study aims to investigate the prevalence of Takotsubo syndrome (TTS) as a percentage of the total number of acute coronary syndrome (ACS), including non-STE-elevation myocardial infarction and ST-elevation myocardial infarction, as well as the short-term outcome of TTS patients before and during the COVID-19 pandemic.
RESULTS: We compared patients from two different periods: (i) Period 1 (before the COVID-19 pandemic): 1 March to 30 December 2019, and (ii) Period 2 (during the COVID-19 pandemic): 1 March to 30 December 2020. The retrospective database was created from the archives of the participating hospitals or electronic hospital systems by trained medical personnel. The subjects\' medical history, cardiovascular risk factors, laboratory values, echocardiography findings, and an in-hospital outcome were variables of interest. Furthermore, propensity score matching analysis was performed to evaluate the short-term prognosis in TTS and ACS patients. Altogether six Austrian centres-(i) 3rd Medical Department of Cardiology and Intensive Care Medicine, Clinic Ottakring, Vienna, Austria; (ii) 5th Medical Department of Cardiology, Clinic Favoriten, Vienna, Austria; (iii) 2nd Medical Department, Hanusch Hospital, Vienna, Austria; (iv) University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Austria; (v) Department of Cardiology, University Hospital Graz, Graz, Austria; (vi) Department of Cardiology and Intensive Medicine, Kepler University Clinic, Linz, Austria-participated in the study. During period 1, 87 (3.5%) patients out of 2482 ACS patients had TTS in all participating centres. During period 2, 71 (2.7%) patients out of 2572 ACS patients had TTS in all participating centres. Accordingly, the prevalence of TTS remained stable irrespective of potential psychologic stress during the COVID pandemic. Furthermore, the baseline characteristics of TTS patients did not change during the COVID-19 pandemic. The prevalence of in-hospital complications [cardiogenic shock (4.6% vs. 4.3%, P = 0.925), ventricle thrombus (1.1% vs. 1.4%, P = 0.885) and in-hospital bleeding (3.4% vs. 1.4%, P = 0.417)] remained stable. The all-cause in-hospital mortality of TTS patients did not change during the COVID-19 pandemic [χ2 (2) = 0.058, P = 0.810]. Moreover, a propensity score matching analysis of all-cause in-hospital mortality between matched TTS and ACS patients showed higher in-hospital mortality in ACS patients during COVID-19 pandemic (P = 0.043).
CONCLUSIONS: Despite the well-known increased psychologic stress during the COVID-19 pandemic, the prevalence of TTS during the COVID-19 pandemic and the short-term clinical outcome in Austria remained unimpacted.
RESULTS: We compared patients from two different periods: (i) Period 1 (before the COVID-19 pandemic): 1 March to 30 December 2019, and (ii) Period 2 (during the COVID-19 pandemic): 1 March to 30 December 2020. The retrospective database was created from the archives of the participating hospitals or electronic hospital systems by trained medical personnel. The subjects\' medical history, cardiovascular risk factors, laboratory values, echocardiography findings, and an in-hospital outcome were variables of interest. Furthermore, propensity score matching analysis was performed to evaluate the short-term prognosis in TTS and ACS patients. Altogether six Austrian centres-(i) 3rd Medical Department of Cardiology and Intensive Care Medicine, Clinic Ottakring, Vienna, Austria; (ii) 5th Medical Department of Cardiology, Clinic Favoriten, Vienna, Austria; (iii) 2nd Medical Department, Hanusch Hospital, Vienna, Austria; (iv) University Clinic of Internal Medicine III, Cardiology and Angiology, Medical University of Innsbruck, Austria; (v) Department of Cardiology, University Hospital Graz, Graz, Austria; (vi) Department of Cardiology and Intensive Medicine, Kepler University Clinic, Linz, Austria-participated in the study. During period 1, 87 (3.5%) patients out of 2482 ACS patients had TTS in all participating centres. During period 2, 71 (2.7%) patients out of 2572 ACS patients had TTS in all participating centres. Accordingly, the prevalence of TTS remained stable irrespective of potential psychologic stress during the COVID pandemic. Furthermore, the baseline characteristics of TTS patients did not change during the COVID-19 pandemic. The prevalence of in-hospital complications [cardiogenic shock (4.6% vs. 4.3%, P = 0.925), ventricle thrombus (1.1% vs. 1.4%, P = 0.885) and in-hospital bleeding (3.4% vs. 1.4%, P = 0.417)] remained stable. The all-cause in-hospital mortality of TTS patients did not change during the COVID-19 pandemic [χ2 (2) = 0.058, P = 0.810]. Moreover, a propensity score matching analysis of all-cause in-hospital mortality between matched TTS and ACS patients showed higher in-hospital mortality in ACS patients during COVID-19 pandemic (P = 0.043).
CONCLUSIONS: Despite the well-known increased psychologic stress during the COVID-19 pandemic, the prevalence of TTS during the COVID-19 pandemic and the short-term clinical outcome in Austria remained unimpacted.
摘要：
目的：本研究旨在调查Takotsubo综合征（TTS）的患病率占急性冠脉综合征（ACS）总数的百分比，包括非STE抬高型心肌梗死和ST抬高型心肌梗死,以及COVID-19大流行之前和期间TTS患者的短期结局。
结果：我们比较了两个不同时期的患者：（i）第一阶段（COVID-19大流行之前）：2019年3月1日至12月30日，和（ii）第二阶段（COVID-19大流行期间）：2020年3月1日至12月30日。回顾性数据库是由训练有素的医务人员从参与医院或电子医院系统的档案中创建的。受试者的病史，心血管危险因素，实验室值，超声心动图检查结果,住院结局是感兴趣的变量.此外，采用倾向评分匹配分析评估TTS和ACS患者的短期预后.总共六个奥地利中心-（i）第三心脏病学和重症监护医学部，Ottakring诊所，维也纳,奥地利；（二）第五内科，诊所最爱，维也纳,奥地利；（三）第二医疗部门，Hanusch医院,维也纳,奥地利；(四)大学内科诊所III，心脏病学和血管学,因斯布鲁克医科大学,奥地利；(五)心内科，格拉茨大学医院,格拉茨,奥地利；(六)心脏病学和重症医学科，开普勒大学诊所,林茨,奥地利参加了这项研究。在第1期期间，所有参与中心的2482名ACS患者中有87名（3.5％）患者患有TTS。在第2期期间，所有参与中心的2572名ACS患者中有71名（2.7％）患者患有TTS。因此，在COVID大流行期间,无论潜在的心理压力如何,TTS的患病率保持稳定.此外，在COVID-19大流行期间,TTS患者的基线特征没有改变.院内并发症的患病率[心源性休克(4.6%vs.4.3%,P=0.925),心室血栓（1.1%vs.1.4%,P=0.885）和住院出血（3.4%vs.1.4%,P=0.417)]保持稳定。在COVID-19大流行期间，TTS患者的全因住院死亡率没有变化[χ2（2）=0.058，P=0.810]。此外，对匹配的TTS和ACS患者的全因院内死亡率的倾向评分匹配分析显示,在COVID-19大流行期间,ACS患者的院内死亡率较高(P=0.043).
结论：尽管众所周知在COVID-19大流行期间心理压力增加，奥地利COVID-19大流行期间TTS的患病率和短期临床结局未受影响.
结果：我们比较了两个不同时期的患者：（i）第一阶段（COVID-19大流行之前）：2019年3月1日至12月30日，和（ii）第二阶段（COVID-19大流行期间）：2020年3月1日至12月30日。回顾性数据库是由训练有素的医务人员从参与医院或电子医院系统的档案中创建的。受试者的病史，心血管危险因素，实验室值，超声心动图检查结果,住院结局是感兴趣的变量.此外，采用倾向评分匹配分析评估TTS和ACS患者的短期预后.总共六个奥地利中心-（i）第三心脏病学和重症监护医学部，Ottakring诊所，维也纳,奥地利；（二）第五内科，诊所最爱，维也纳,奥地利；（三）第二医疗部门，Hanusch医院,维也纳,奥地利；(四)大学内科诊所III，心脏病学和血管学,因斯布鲁克医科大学,奥地利；(五)心内科，格拉茨大学医院,格拉茨,奥地利；(六)心脏病学和重症医学科，开普勒大学诊所,林茨,奥地利参加了这项研究。在第1期期间，所有参与中心的2482名ACS患者中有87名（3.5％）患者患有TTS。在第2期期间，所有参与中心的2572名ACS患者中有71名（2.7％）患者患有TTS。因此，在COVID大流行期间,无论潜在的心理压力如何,TTS的患病率保持稳定.此外，在COVID-19大流行期间,TTS患者的基线特征没有改变.院内并发症的患病率[心源性休克(4.6%vs.4.3%,P=0.925),心室血栓（1.1%vs.1.4%,P=0.885）和住院出血（3.4%vs.1.4%,P=0.417)]保持稳定。在COVID-19大流行期间，TTS患者的全因住院死亡率没有变化[χ2（2）=0.058，P=0.810]。此外，对匹配的TTS和ACS患者的全因院内死亡率的倾向评分匹配分析显示,在COVID-19大流行期间,ACS患者的院内死亡率较高(P=0.043).
结论：尽管众所周知在COVID-19大流行期间心理压力增加，奥地利COVID-19大流行期间TTS的患病率和短期临床结局未受影响.
