Renal impairment and outcome in Takotsubo syndrome: Insights from a national multicentric cohort

Int J Cardiol. 2024 Jun 15:405:131971. doi: 10.1016/j.ijcard.2024.131971. Epub 2024 Mar 14.

Abstract

Introduction: Data on the association between kidney function and Takotsubo syndrome (TTS) outcomes are scarce and conflictive.

Objective: To assess the impact of chronic kidney disease (CKD) and acute renal failure (ARF) in patients with TTS.

Material and methods: Patients from the prospective nation-wide (RETAKO) registry were included and divided into quartiles of maximum creatinine (Cr) level during hospitalization.

Results: The prevalence of CKD and ARF in the whole RETAKO cohort was 5.4% and 11.7%, respectively. Compared to Q1 (Cr <0.71), patients within Q4 (Cr > 1.1) had lower left ventricular ejection fraction on admission (38.5 ± 12 vs 43.3 ± 11.3, p = 0.002) and higher bleeding rates during hospitalization (6.7% vs 2%, p = 0.005). In addition, compared to Q1, Q4 patients have a greater incidence of cardiogenic shock (17.3% vs 5.6%, p < 0.001), and a higher rate of 5-year all-cause death and major adverse cardiovascular events (31.5% vs 15.8%, p < 0.001 and 22.5% vs 9.3%, p < 0.001, respectively).

Conclusions: TTS patients with CKD have a higher incidence of ARF and exhibit greater Cr on admission, which were linked with higher rates of cardiogenic shock, bleeding during hospitalization as well as major adverse cardiovascular events and all-cause death during a 5-year follow-up.

Keywords: Chronic kidney disease; Death; Prognosis; Renal failure; Takotsubo syndrome.

Publication types

  • Multicenter Study

MeSH terms

  • Acute Kidney Injury / diagnosis
  • Acute Kidney Injury / epidemiology
  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • Registries*
  • Renal Insufficiency, Chronic* / complications
  • Renal Insufficiency, Chronic* / epidemiology
  • Takotsubo Cardiomyopathy* / complications
  • Takotsubo Cardiomyopathy* / diagnosis
  • Takotsubo Cardiomyopathy* / epidemiology
  • Takotsubo Cardiomyopathy* / physiopathology
  • Treatment Outcome