Risk stratification using the CHA2DS2-VASc score in Takotsubo syndrome: Data from the Takotsubo Italian network
- Autori: Parodi G.; Scudiero F.; Citro R.; Silverio A.; Bellandi B.; Zito C.; Antonini-Canterin F.; Rigo F.; Zocchi C.; Bossone E.; Salerno-Uriarte J.; Piscione F.; Di Mario C.; Armentano C.; Astarita C.; Coppola A.; Ravera A.; Prota C.; Bottiglieri P.; Bovelli D.; Patella M.M.; Costantino M.F.; Gregorio G.; Santoro M.; Manganelli F.; Rotondi F.; Del Pace S.; Pascotto M.; Grolla E.; Tagliamonte E.; Bianchi A.; Marinosci G.; Pappalettera M.; Pozzi A.; Nardi F.; Novo G.; Bovenzi F.
- Anno di pubblicazione: 2017
- Tipologia: Articolo in rivista (Articolo in rivista)
- Parole Chiave: Anticoagulant; Cardiovascular events; CHA; 2; DS; 2; -VASc score; Stroke; Takotsubo; Takotsubo cardiomyopathy; Takotsubo syndrome;
- OA Link: http://hdl.handle.net/10447/265282
Abstract
Background--The CHA2DS2-VASc score predicts stroke in patients with atrial fibrillation and has been reported to have a prognostic role even in acute coronary syndrome patients. The Takotsubo syndrome is a condition that mimics acute coronary syndrome and may present several complications including stroke. We sought to assess the ability of CHA2DS2-VASc score to predict adverse events in Takotsubo syndrome patients. Methods and Results--Overall, 371 Takotsubo syndrome patients were enrolled in a prospective registry. Patients were divided into 3 groups according to the CHA2DS2-VASc score: Group A (≤1), B (2-3), and C (≥4). The median CHA2DS2-VASc score was 3 (interquartile range: 2-4). Overall, 9%, 42%, and 49% were included in Group A, B, and C, respectively. Follow-up length was 26±20 months. The mortality rate was 6%, 7%, and 17% in Group A, B, and C, respectively (P= 0.011). The stroke rate was 3% and not different among the 3 groups. Estimated major adverse cardiac and cerebrovascular events (the composite of death, myocardial infarction, and stroke) rates in the 3 groups were 6%, 9%, and 17% in Group A, B, and C, respectively (P=0.033). The CHA2DS2-VASc score resulted as a predictor of major adverse cardiac and cerebrovascular events (odds ratio 2.1, 95% confidence interval, 1.2-3.6; P=0.01) and all-cause mortality (odds ratio 1.5, 95% confidence interval, 1.2-1.9; P=0.001). Conclusions--In Takotsubo syndrome, the CHA2DS2-VASc score allows prediction of cardiovascular events and mortality at longterm follow-up.