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Comparison of clinical profiles between takotsubo syndrome and acute coronary syndrome: a systematic review and meta-analysis

  • Pei-lun Han
  • Zhi-gang YangEmail author
  • Kai-yue Diao
  • Shan Huang
  • Meng-ting Shen
  • Yi Zhang
  • Sen He
  • Ying-kun GuoEmail author
Article

Abstract

A systematic review and meta-analysis were performed to analyse the differences in clinical profiles between takotsubo syndrome (TTS) and acute coronary syndrome (ACS) patients and to consolidate the evidence regarding the mortality predictors in TTS patients. Literature search of PubMed, EMBASE and the Cochrane Central Register was made, and 55 studies with a total of 66,653 TTS patients were included. Compared with ACS subjects, TTS subjects had significantly lower left ventricle ejection fraction (LVEF) values on admission; however, cardiovascular risks were fewer and the recovery LVEF was notably higher at both discharge and follow-up in TTS patients than in ACS patients (all P < 0.05). No significant differences were observed either in-hospital mortality or long-term mortality between the two groups (both P > 0.05). Acute renal failure and malignancies were independent predictors of all-cause in-hospital mortality in TTS patients (both P < 0.05). Male sex (HR = 0.565, 95% CI 0.253–0.876, P < 0.001, I2 = 0.00%), advanced age (HR = 0.054, 95% CI 0.041 to 0.067, P < 0.001, I2 = 0.00%), shock (HR = 1.382. 95% CI 1.050 to 1.714, P < 0.001, I2 = 0.00%) and initial LVEF < 35% (HR = 0.962, 95% CI 0.948 to 0.977, P < 0.001, I2 = 16.8%) were associated with an increased risk of long-time mortality in TTS patients. In conclusion, TTS has significantly different clinical characteristics than ACS. However, the in-hospital and long-term overall mortality rates are not trivial for TTS patients, and some presenting features (underlying diseases, male sex, advanced age, low LVEF and shock) were significantly associated with all-cause mortality.

Keywords

Takotsubo syndrome Acute coronary syndrome Prognosis Meta-analysis 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Supplementary material

10741_2019_9846_MOESM1_ESM.pdf (1.9 mb)
ESM 1 (PDF 1961 kb)

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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Pei-lun Han
    • 1
  • Zhi-gang Yang
    • 1
    Email author
  • Kai-yue Diao
    • 1
  • Shan Huang
    • 1
  • Meng-ting Shen
    • 1
  • Yi Zhang
    • 1
  • Sen He
    • 2
  • Ying-kun Guo
    • 3
    Email author
  1. 1.Department of Radiology, State Key Laboratory of Biotherapy, West China HospitalSichuan UniversityChengduChina
  2. 2.Department of Cardiology, West China HospitalSichuan UniversityChengduChina
  3. 3.Department of Radiology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of Ministry of education, West China Second University HospitalSichuan UniversityChengduChina

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