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Article Dans Une Revue Circulation Journal Année : 2020

Systemic Inflammatory Response Syndrome Is a Major Determinant of Cardiovascular Outcome in Takotsubo Syndrome

Benjamin Marchandot
  • Fonction : Auteur
Kensuke Matsushita
  • Fonction : Auteur
Charlotte Dagrenat
  • Fonction : Auteur
Marilou Peillex
  • Fonction : Auteur
Chisato Sato
  • Fonction : Auteur
Antonin Trimaille
  • Fonction : Auteur
Antje Reydel
  • Fonction : Auteur
Annie Trinh
  • Fonction : Auteur
Patrick Ohlmann
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  • PersonId : 1084292
Laurence Jesel
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  • PersonId : 1118747
Olivier Morel
  • Fonction : Auteur
  • PersonId : 1102510

Résumé

BACKGROUND: Recent insights have emphasized the importance of inflammatory response in takotsubo syndrome (TTS). We sought to evaluate the predictors of systemic inflammatory response syndrome (SIRS) and its impact on cardiovascular mortality after TTS.Methods and Results:The 215 TTS patients were retrospectively included between September 2008 and January 2018. SIRS was diagnosed in 96 patients (44.7%). They had lower left ventricular ejection fraction (LVEF) on admission (34.5% vs. 41.9%; P<0.001) and higher peak brain natriuretic peptide and troponin. At a median follow-up of 518 days, SIRS was associated with increased in-hospital mortality (14.6% vs. 5.0%; P=0.019), overall mortality (29.4% vs. 10.8%; P=0.002), and cardiovascular mortality (10.6% vs. 2.1%; P=0.026). A history of cancer (OR, 3.36; 95% CI: 1.54-7.31; P=0.002) and LVEF <40% at admission (OR, 2.31; 95% CI: 1.16-4.58; P=0.017) were identified as independent predictors of SIRS. On multivariate Cox regression analysis, SIRS (HR, 12.8; 95% CI: 1.58-104; P=0.017), age (HR, 1.09; 95% CI: 1.02-1.16; P=0.01), and LVEF <40% at discharge (HR, 9.88; 95% CI: 2.54-38.4; P=0.001) were independent predictors of cardiovascular death. CONCLUSIONS: SIRS was found in a large proportion of TTS patients and was associated with enhanced myocardial damage and adverse outcome in the acute phase. At long-term follow-up, SIRS remained an independent factor of cardiovascular death.

Dates et versions

hal-03781998 , version 1 (20-09-2022)

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Citer

Lucie Lachmet-Thébaud, Benjamin Marchandot, Kensuke Matsushita, Charlotte Dagrenat, Marilou Peillex, et al.. Systemic Inflammatory Response Syndrome Is a Major Determinant of Cardiovascular Outcome in Takotsubo Syndrome. Circulation Journal, 2020, 84 (4), pp.592-600. ⟨10.1253/circj.CJ-19-1088⟩. ⟨hal-03781998⟩

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