Cardiogenic Shock Associated With Poor Clinical Outcomes in Takotsubo Syndrome

Patients with broken heart syndrome complicated by cardiogenic shock remain at a greater risk for death years after the initial event.

The following article is part of conference coverage from the 2018 AHA Scientific Sessions in Chicago, Illinois.The Cardiology Advisor’s staff will be reporting breaking news associated with research conducted by leading experts in cardiology. Check back for the latest news from AHA 2018.

CHICAGO — Patients with Takotsubo syndrome (TTS), also known as broken heart syndrome, in whom cardiogenic shock develops remain at a greater risk for death years after the initial event, according to a study presented at the 2018 AHA Scientific Sessions1 in Chicago, Illinois, from November 10-14.

Christian Templin, MD, PhD, and colleagues sought to learn more about risk factors and outcomes when cardiogenic shock occurs in patients with TTS.

Using data from the International Takotsubo Registry (N=2078), a multicenter observational registry, the researchers compared data from patients in whom cardiogenic shock developed after a TTS diagnosis (n=198, average age 63.4 years, 14.1% men) with data from patients with TTS without cardiogenic shock (n=1880, average age 67.2 years, 9.3% men).

The results showed that people with TTS who experienced cardiogenic shock were more likely to:

  • Have TTS triggered by physical stress (66.7% vs 33%)
  • Have lower left ventricular ejection fraction readings (32.7% vs 41.6%) when admitted to the hospital
  • Have radiographs or ultrasounds showing apical ballooning of the left ventricle (80.3% vs 70.2%)
  • Have lower rates of taking angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers (30.3% vs. 39.1%) and statins (13.2% vs. 20.7%)

Patients with TTS who had cardiogenic shock had a less favorable 5-year survival rate than those with TTS who did not have cardiogenic shock (P <0.001).

“The history and parameters that are easily detectable on admission to the hospital could be helpful to identify [patients with TTS] at higher risk of developing cardiogenic shock,” said Christian Templin, MD, PhD, lead author of the study, in a press release that accompanied the study release.2

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“For such patients, close monitoring could reveal initial signs of cardiogenic shock and allow prompt management.”

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1. Templin C, Di Vece D, Citro R, et al. Cardiogenic Shock in Takotsubo Syndrome. Presented at: American Heart Association Scientific Sessions 2018. November 10-12, 2018; Chicago, Ill. Abstract SaMDP9.

2. Complication of broken heart syndrome associated with both short- and long-term risk of death [news release]. Dallas, TX: American Heart Association. [] November 5, 2018. Accessed November 7, 2018.