Differences in Clinical Features and In-Hospital Outcomes of Older Adults with Tako-Tsubo Cardiomyopathy

作者：Citro Rodolfo^*; Rigo Fausto; Previtali Mario; Ciampi Quirino; Canterin Francesco Antonini; Provenza Gennaro; Giudice Roberta; Patella Marco Mariano; Vriz Olga; Mehta Rahul; Baldi Cesare; Mehta Rajendra H; Bossone Eduardo

来源：Journal of the American Geriatrics Society, 2012, 60(1): 93-98.

DOI：10.1111/j.1532-5415.2011.03730.x

• Tako-tsubo cardiomyopathy
• age
• outcomes
• elderly

OBJECTIVES: To describe the clinical characteristics and in-hospital outcomes of older adults with tako-tsubo cardiomyopathy (TTC). %26lt;br%26gt;DESIGN: Partially retrospective, partially prospective observational study. %26lt;br%26gt;SETTING: Eleven Italian referral cardiac centers included in the Tako-tsubo Italian Network. %26lt;br%26gt;PARTICIPANTS: One hundred ninety consecutive individuals with TTC (92.1% female, mean age 66) were divided into three groups according to age (%26lt;65, n = 78; 65-74, n = 61; %26gt;= 75, n = 51). %26lt;br%26gt;MEASUREMENTS: Clinical findings and in-hospital outcomes were evaluated in each group. %26lt;br%26gt;RESULTS: Participants aged 65 and older had a greater prevalence of hypertension (P = .001) and a lower glomerular filtration rate (P %26lt; .001), and those aged 65 to 74 had a greater prevalence of psychiatric disorders (P = .01), ST-segment elevation on admission (P = .01) and a cerebrovascular disease (P = .003) than those younger than 65. Despite similar left ventricular ejection fraction (LVEF) on admission (P = .26), the oldest group had a lower LVEF at discharge (P = .03). Inotropic agents were used more frequently in older adults (P = .03). In-hospital composite adverse events (all-cause death, acute heart failure, life-threatening arrhythmias, stroke, and cardiogenic shock; P = .03) and overall complications (P = .004) were more common in participants aged 75 and older. Overall in-hospital mortality was low (2.8%) but was more prevalent in participants aged 75 and older (6.3%). On multivariate analysis, age of 75 and older (hazard ratio (HR) = 2.45, 95% confidence interval (CI) = 1.28-5.82, P = .04) and LVEF on admission (HR = 0.874, 95% CI = 0.81-0.95, P %26lt; .001) were the only independent predictors of in-hospital adverse events. %26lt;br%26gt;CONCLUSION: The clinical profile of participants aged 75 and older with TTC was different from that of those younger than 75 with TTC, and they had a higher in-hospital complication rate. J Am Geriatr Soc 60:93-98, 2012.

• 出版日期2012-1