Younger Takotsubo syndrome patients at increased risk of severe complications

Takotsubo syndrome (TS) more commonly occurs in patients aged <50 years and may result in severe complications that require intensive care, especially in younger individuals, reveals a study.

To examine age-related variations in TS, the investigators analysed patients diagnosed with TS and enrolled in the International Takotsubo Registry between January 2011 and February 2017. Participants were then stratified by age: younger (≤50 years), middle-aged (51–74 years) and elderly (≥75 years). Between-group comparisons on baseline characteristics, hospital course, and short- and long-term mortality were then performed

A total of 2,098 TS patients were included, of whom 242 (11.5 percent) were younger, 1,194 (56.9 percent) were middle-aged and 662 (31.6 percent) were elderly individuals.

Younger patients, compared with middle-aged and elderly, were more often men (12.4 percent vs 10.9 percent vs 6.3 percent; p=0.002) and likely to have acute neurological (16.3 percent vs 8.4 percent vs 8.8 percent; p=0.001) or psychiatric disorders (14.1 percent vs 10.3 percent vs 5.6 percent; p<0.001). They were also more likely to experience cardiogenic shock (15.3 percent vs 9.1 percent vs 8.1 percent; p=0.004) and a higher in-hospital mortality (6.6 percent vs 3.6 percent vs 5.1 percent; p=0.07).

Multivariable analysis revealed that younger (odds ratio [OR], 1.60, 95 percent confidence interval [CI], 0.86–3.01; p=0.14) and older age (OR, 1.09, 95 percent CI, 0.66–1.80; p=0.75) did not independently correlate with in-hospital mortality, with the middle-aged groups used a reference. No between-group differences in 60-day mortality rates were observed.

“TS occurs predominantly in postmenopausal women but is also found in younger patients,” the investigators noted.