Abstract
Takotsubo syndrome (TTS) is an acute cardiomyopathy characterised by transient systolic dysfunction (lasting hours to weeks) of the left ventricle (LV), usually presenting with apical akinesia without evidence of obstructive coronary artery disease. To date, no clear cause has been identified, and it has been understood as a condition with a generally benign course. However, several studies have shown that diabetes mellitus is a relevant comorbidity that influences the occurrence of this condition but could affect its prognosis. The aim of this study was to assess the influence of diabetes mellitus (DM) on the long-term outcomes of patients diagnosed with TTS, who were admitted to the cardiovascular critical care unit (CCU) of our hospital..
A retrospective observational analysis of patients (p) with TTS and DM was conducted, comparing them to those without DM in a series of 87 patients admitted to the CCU of our hospital between 2012 and 2023.
Out of the 87 TTS patients, 25 were diabetic (28.7%). TTS patients with DM were more frequently women (84%) with a mean age of 73 years. Some had arterial hypertension (84%), dyslipidaemia (56%), previous ischaemic heart disease (12%), and atrial fibrillation (20%). Mortality during CCU admission was higher in the TTS-DM cohort (20.2% vs. 0%), and they showed greater progression to cardiogenic shock (16% vs. 8.5%), a higher need for circulatory support with dobutamine (16% vs. 8%) and noradrenaline (16% vs. 9.7%), a greater incidence of new-onset atrial fibrillation (16.6% vs. 1.6%), and a greater need for invasive mechanical ventilation (4.2% vs. 1.6%) and non-invasive mechanical ventilation (8.3% vs. 6.5%). However, there were no differences regarding the use of intra-aortic balloon pump (IABP) or Impella. No ventricular arrhythmias were recorded during follow-up.
Author notes
Funding Acknowledgements: None.
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