Takotsubo syndrome and cancer, clinical and prognostic implications, insights of RETAKO

Med Clin (Barc). 2020 Dec 24;155(12):521-528. doi: 10.1016/j.medcli.2020.01.033. Epub 2020 May 17.
[Article in English, Spanish]

Abstract

Background and objectives: A relationship between neoplasms and Takotsubo syndrome (TS) has been postulated. Our goal was to determine its prevalence in patients with TS, compare the clinical profile of TS with or without cancer and study its long-term evolution.

Materials and methods: The oncological situation of patients included in the National Registry on TAKOtsubo syndrome (RETAKO), admitted between 2002 and 2019, provided by 38 hospitals throughout the country is analysed. Any history of malignancy or tumour, even benign, that received chemotherapy, radiotherapy or specific surgery, current or past, was considered.

Results: Any type of neoplasm was described in 129 (11.8%), within a cohort of 1,097 patients with TS. The cohort of patients with neoplasm, with a lower percentage of women (79.1 vs. 88.3%; P=.003), showed a non-significant tendency at an older age, hyperuricaemia, sleep apnoea and lower LVEF on admission, with a similar cardiovascular risk factor profile, but more chronic anaemia and immunosuppression. The most common neoplasm was breast cancer. During their hospital stay, the cancer patients suffered more complications, highlighting heart failure/shock, acute renal failure and a trend towards combined infections. On follow-up, they presented higher mortality and more combined MACE events, with a non-significant trend in the occurrence of cardiovascular recurrences or readmissions.

Conclusions: The prevalence of neoplasms in patients with TS is high. The clinical presentation is different in relation to patients who do not have neoplasms and they probably represent a risk factor for a worse hospital and long term prognosis.

Keywords: Neoplasia; Neoplasm; Oncology; Oncología; RETAKO; Takotsubo.

MeSH terms

  • Aged
  • Female
  • Heart Failure* / epidemiology
  • Heart Failure* / etiology
  • Hospitalization
  • Humans
  • Neoplasm Recurrence, Local
  • Prognosis
  • Takotsubo Cardiomyopathy* / diagnosis
  • Takotsubo Cardiomyopathy* / epidemiology