Email this article Prediction of in-hospital complications in takotsubo syndrome: prospective cohort study
- Authors: Evdokimov D.S.1, Feoktistova V.S.1, Boldueva S.A.1, Resnyanskaya E.D.1, Plavinsky S.L.1
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Affiliations:
- Mechnikov North-Western State Medical University
- Issue: Vol 15, No 1 (2024)
- Pages: 5-18
- Section: Original study articles
- URL: https://journals.rcsi.science/2221-7185/article/view/256929
- DOI: https://doi.org/10.17816/CS623576
- ID: 256929
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Abstract
BACKGROUND: Until recently, takotsubo syndrome (TS) was considered a fairly benign disease in both early and late periods. However, in recent years, in-hospital complications in the acute period of TS are common and can be life-threatening.
AIM: Based on clinical and laboratory-instrumental data, this study aimed to build models for predicting the risk of developing in-hospital complications in patients with TS during the acute period.
MATERIALS AND METHODS: This prospective cohort study included 60 patients with TS, with an average age of 65.5±13.4 years. In the acute period (7–14 days), standard clinical and laboratory examination, peripheral arterial tonometry using the «EndoPAT 2000» apparatus, and psychological testing using validated questionnaires (hospital anxiety and depression scale and Beck depression scale) were performed.
RESULTS: The integrated model for predicting the risk of acute heart failure (AHF) development (pulmonary edema and cardiogenic shock) identified admission LVEF as the leading prognostic parameter. With LVEF ≤40.5%, the probability of AHF in patients with TS in the acute period was 62.5%, and in patients with TS and QTc interval >487 ms, the risk reached 100%. The sensitivity and specificity of the developed model were 72.7% and 97.4%, respectively. The integrated model for predicting the development of cardiovascular complications (CVCs) revealed that the number of leukocytes in the peripheral blood was the leading risk factor for adverse events in patients with TS in the acute period. With a leukocyte count >11.1×109/L, the risk of CVCs in patients with TS increased to 89.9%, and if the erythrocyte count was >4.69×1012/L or ≤4.29×1012/L, it could reach 100%. The sensitivity and specificity of the resulting model were 92.6 and 97.0%, respectively.
CONCLUSION: The models proposed in this study for predicting the likelihood of developing severe AHF and the overall risk of CVCs in the acute period of TS are personalized and easy to use, allowing for the selection of optimized treatment techniques.
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##article.viewOnOriginalSite##About the authors
Dmitry S. Evdokimov
Mechnikov North-Western State Medical University
Author for correspondence.
Email: kasabian244@gmail.com
ORCID iD: 0000-0002-3107-1691
graduate student
Russian Federation, St. PetersburgValeria S. Feoktistova
Mechnikov North-Western State Medical University
Email: lerissima@yandex.ru
ORCID iD: 0000-0003-4161-3535
MD, Cand. Sci. (Med.), associate professor
Russian Federation, PetersburgSvetlana A. Boldueva
Mechnikov North-Western State Medical University
Email: svetlanaboldueva@mail.ru
ORCID iD: 0000-0002-1898-084X
MD, Dr. Sci. (Med.), Professor, department head
Russian Federation, St. PetersburgEkaterina D. Resnyanskaya
Mechnikov North-Western State Medical University
Email: svetlanaboldueva@mail.ru
ORCID iD: 0000-0001-7889-3679
student
St. PetersburgSvyatoslav L. Plavinsky
Mechnikov North-Western State Medical University
Email: s.plavinskij@gmail.com
ORCID iD: 0000-0001-9159-6177
MD, Dr. Sci. (Med.), department professor
Russian Federation, St. PetersburgReferences
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