Prevalence of Malignancy High in Takotsubo Syndrome Patients

Overall, 16.6 percent of patients with takotsubo syndrome (TTS) have malignancy, and long-term mortality is higher in patients with malignancy, according to a study published online in the Journal of the American Heart Association.

Victoria L. Cammann, M.D., from the University Heart Center in Zurich, and colleagues enrolled TTS patients and divided the cohort into patients with and without malignancy to examine differences in clinical characteristics and assess short- and long-term malignancy. A subanalysis was performed to compare long-term mortality for a subset of TTS patients with or without malignancy and acute coronary syndrome (ACS) patients with or without malignancy.

The researchers found that 16.6 percent of 1,604 TTS patients had malignancy. Compared with patients without malignancy, patients with malignancy were older and more likely to have physical triggers but less likely to have emotional triggers. Patients with malignancy had higher long-term mortality (P < 0.001), while short-term outcomes were comparable (P = 0.17). Comparable long-term mortality was seen for TTS patients with malignancies and ACS patients with malignancies (P = 0.13). Malignancy independently predicted long-term mortality.

"The findings of the present study have unraveled a high prevalence of malignancy in TTS patients," the authors write. "Our findings suggest that specific malignancy-associated factors impact the development and outcome of TTS. Therefore, to fully understand the pathophysiology of TTS and the role of malignancy in triggering or affecting outcomes, this subset of patients deserves further investigation."

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