Stahli, Barbara E. and Schindler, Matthias and Schweiger, Victor and Cammann, Victoria L. and Szawan, Konrad A. and Niederseer, David and Wurdinger, Michael and Schonberger, Alexander and Schonberger, Maximilian and Koleva, Iva and Mercier, Julien C. and Petkova, Vanya and Mayer, Silvia and Citro, Rodolfo and Vecchione, Carmine and Bossone, Eduardo and Gili, Sebastiano and Neuhaus, Michael and Franke, Jennifer and Meder, Benjamin and Jaguszewski, Milosz and Noutsias, Michel and Knorr, Maike and Jansen, Thomas and D'Ascenzo, Fabrizio and Dichtl, Wolfgang and von Lewinski, Dirk and Burgdorf, Christof and Kherad, Behrouz and Tschoepe, Carsten and Sarcon, Annahita and Shinbane, Jerold and Rajan, Lawrence and Michels, Guido and Pfister, Roman and Cuneo, Alessandro and Jacobshagen, Claudius and Karakas, Mahir and Koenig, Wolfgang and Pott, Alexander and Meyer, Philippe and Roffi, Marco and Banning, Adrian and Wolfrum, Mathias and Cuculi, Florim and Kobza, Richard and Fischer, Thomas A. and Vasankari, Tuija and Airaksinen, K. E. Juhani and Napp, L. Christian and Dworakowski, Rafal and MacCarthy, Philip and Kaiser, Christoph and Osswald, Stefan and Galiuto, Leonarda and Chan, Christina and Bridgman, Paul and Beug, Daniel and Delmas, Clement and Lairez, Olivier and Gilyarova, Ekaterina and Shilova, Alexandra and Gilyarov, Mikhail and El-Battrawy, Ibrahim and Akin, Ibrahim and Polednikova, Karolina and Tousek, Petr and Winchester, David E. and Massoomi, Michael and Galuszka, Jan and Ukena, Christian and Poglajen, Gregor and Carrilho-Ferreira, Pedro and Hauck, Christian and Paolini, Carla and Bilato, Claudio and Kobayashi, Yoshio and Kato, Ken and Ishibashi, Iwao and Himi, Toshiharu and Din, Jehangir and Al-Shammari, Ali and Prasad, Abhiram and Rihal, Charanjit S. and Liu, Kan and Schulze, P. Christian and Bianco, Matteo and Jorg, Lucas and Rickli, Hans and Pestana, Goncalo and Nguyen, Thanh H. and Bohm, Michael and Maier, Lars S. and Pinto, Fausto J. and Widimsky, Petr and Felix, Stephan B. and Braun-Dullaeus, Ruediger C. and Rottbauer, Wolfgang and Hasenfu, Gerd and Pieske, Burkert M. and Schunkert, Heribert and Budnik, Monika and Opolski, Grzegorz and Thiele, Holger and Bauersachs, Johann and Horowitz, John D. and Di Mario, Carlo and Kong, William and Dalakoti, Mayank and Imori, Yoichi and Liberale, Luca and Montecucco, Fabrizio and Munzel, Thomas and Crea, Filippo and Luscher, Thomas F. and Bax, Jeroen J. and Ruschitzka, Frank and Ghadri, Jelena R. and Di Vece, Davide and Templin, Christian (2024) Cardiac troponin elevation and mortality in takotsubo syndrome: New insights from the international takotsubo registry. EUROPEAN JOURNAL OF CLINICAL INVESTIGATION, 54 (12): e14317. ISSN 0014-2972, 1365-2362
Full text not available from this repository. (Request a copy)Abstract
Background: The clinical relevance of cardiac troponin (cTn) elevation in takotsubo syndrome (TTS) remains uncertain. The present study sought to investigate the role of cardiac troponin (cTn) elevations in mortality prediction of patients with Takotsubo syndrome (TTS). Methods: Patients enrolled in the International Takotsubo (InterTAK) Registry from January 2011 to February 2020 with available data on peak cTn levels were included in the analysis. Peak cTn levels during the index hospitalization were used to define clinically relevant myocardial injury. The threshold at which clinically relevant myocardial injury drives mortality at 1year was identified using restricted cubic spline analysis. Results: Out of 2938 patients, 222 (7.6%) patients died during 1-year follow-up. A more than 28.8-fold increase of cTn above the upper reference limit was identified as threshold for clinically relevant myocardial injury. The presence of clinically relevant myocardial injury was significantly associated with an increased risk of mortality at 5years (adjusted HR 1.58, 95% CI 1.18-2.12, p=.002). Clinically relevant myocardial injury was related to an increased 5-year mortality risk in patients with apical TTS (adjusted HR 1.57, 95% CI 1.21-2.03, p=.001), in presence of physical stressors (adjusted HR 1.60, 95% CI 1.22-2.11, p=.001), and in absence of emotional stressors (adjusted HR 1.49, 95% CI, 1.17-1.89, p=.001). Conclusion: This study for the first time determined a troponin threshold for the identification of TTS patients at excess risk of mortality. These findings advance risk stratification in TTS and assist in identifying patients in need for close monitoring and follow-up.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | MYOCARDIAL INJURY; CARDIOMYOPATHY; DEFINITION; FEATURES; OUTCOMES; myocardial injury; risk prediction; takotsubo syndrome; troponin |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin II |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 23 Jul 2025 09:04 |
| Last Modified: | 23 Jul 2025 09:04 |
| URI: | https://pred.uni-regensburg.de/id/eprint/65759 |
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