131 Cancer and takotsubo syndrome: clinical features, outcome, and inflammatory patterns. Results from a multicentre prospective registry. (8th December 2021)

• Record Type: Journal Article
• Authors: Vitale, Enrica; Santoro, Francesco; Leopizza, Alessandra; Mallardi, Adriana; Iacoviello, Massimo; Brunetti, Natale Daniele
• Is Part Of: European heart journal supplements. Volume 23(2021)Supplement G
• Publication Date: 2021-12-08
• Subjects: Cardiology -- Periodicals; Cardiology -- Europe -- Periodicals; 616.12005
• DOI: 10.1093/eurheartj/suab142.058
• Languages: English
• ISSNs: 1520-765X

Abstract

Abstract: Aims: Cancer represents one of the major determinants of prognosis in patients with Takotsubo Syndrome (TTS). Aim of this study was therefore to compare clinical features, short- and long-term outcome and inflammatory pattern among TTS patients with history of cancer. Methods and results: 412 consecutive patients with TTS were enrolled in a multicentre prospective registry from July 2007 to February 2021. Clinical features, in and out of hospital MACE, laboratory and imaging data were collected. A sub-analysis evaluating serum interleukins levels among 12 patients with cancer vs. a propensity score matched cohort was performed. Prevalence of history of cancer was 12% ( N = 51 pts). Patients with history of cancer were older (77 vs. 72 years, P = 0.01), with a higher percentage of male (23.5% vs. 8.8%, P = 0.01). Diabetes, dyslipidemia, and obesity were more prevalent in patients with cancer (29% vs. 22%, 49% vs. 42%, 25.5% vs. 18.5%, P = 0.01 respectively), while a similar prevalence was found for hypertension and smoke. Left ventricular ejection fraction (LVEF) at admission and discharge was lower in patients with history of cancer (33% vs. 37%, 44% vs. 50%. P = 0.03 respectively). Patients with cancer showed higher incidence of in hospital events (41% vs. 33%, P = 0.01) mainly driven by cardiogenic shock (21.5% vs. 8.5% P = 0.01), in hospital death (13.7% vs. 4.7%, P = 0.01), left ventricular thrombi (9.8% vs. 3.3%, P = 0.01) and ventricular arrhythmias (13.7% vs. 7.4%, P = 0.01). The long-term mortality was higher in patients with history of cancer (31.3% vs. 11.3%, P = 0.01). A distinct inflammatory pattern was found in cancer patients: at admission there were higher levels of IL 2 and VEGF levels (IL-2 3.3 vs. 0.7 pg/ml, P = 0.05, VEGF 476.3 vs. 249.5 pg/ml, P = 0.03); at discharge IL-4 was lower (1.17 pg/ml vs. 2.49 pg/ml, P = 0.04) while VEGF remained higher in subjects with TTS and cancer (406 vs. 128 pg/ml, P = 0.03). Conclusions: Cancer patients with TTS are characterized by different clinical features, epidemiological characteristics, worse prognosis and higher long-term mortality when compared to patients with TTS without history of malignancy. A distinct inflammatory pattern can be found in this subset of TTS patients.