Kidney Failure among Patients with Takotsubo Syndrome or Myocardial Infarction: A Retrospective Analysis
Abstract
:1. Introduction
2. Materials and Methods
3. Statistics
4. Results
4.1. Baseline Demographics
4.2. Clinical Presentation
4.3. Echocardiographic Characteristics
4.4. In-Hospital Outcomes
4.5. Long-Term Outcomes
5. Discussion
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variables | TTS (n = 61) | MI (n = 164) | p Value * |
---|---|---|---|
Demographics | |||
Age. Mean ± SD | 69 ± 11 | 71 ± 11 | 0.12 |
Female (%) | 47 (77.0) | 40 (24.4) | <0.01 |
Symptoms. N (%) | |||
Dyspnoe | 24 (39.3) | 53 (32.3) | 0.32 |
Chest pain | 31 (51.7) | 118(72.0) | <0.01 |
Clinic parameter | |||
Systolic BP. mmHg | 132 (90–200) | 137 (80–250) | 0.65 |
Diastolic BP. mmHg | 77 (50–110) | 77 (30–150) | 0.55 |
Heart rate. Bpm | 100 ± 25 | 79 ± 19 | <0.01 |
ECG Data. N (%) | |||
ST-segment elevation | 16 (26.2) | 74 (45.1) | 0.01 |
Inversed T-Waves | 56 (93.3) | 119 (72.6) | <0.01 |
PQ-interval | 166 ± 28 | 173 ± 33 | <0.01 |
QTc (ms) | 468 (374–554) | 448 (324–569) | 0.53 |
Laboratory values. Mean ± SD | |||
Troponin I (U/L) (IQR) | 48.13 (0.01–2631) | 28.83 (0.01–1704) | 0.50 |
Creatine phosphatkinase (U/L) (IQR) | 993 (39–26,600) | 909 (30–12,092) | 0.39 |
CKMB (U/L) (IQR) | 43 (2–415) | 88 (0–1208) | 0.34 |
C-Reactive protein (mg/L) (IQR) | 61.3 (0.4–467.1) | 34.3 (0.0–247.9) | 0.34 |
Hemoglobin (g/dL) (IQR) | 12.0 ± 2.4 | 13.2 ±2.4 | 0.03 |
Creatinine (mg/dL) (IQR) | 1.52 (1.01–2.83) | 1.50 (1.00–12.16) | 0.38 |
Echocardiography data. N (%) | |||
LV EF% | 37 ± 10 | 48 ± 14 | <0.01 |
LV EF% follow-up | 49 ± 14 | 48 ± 14 | 1.00 |
Mitral regurgitation | 33 (54.1) | 66 (40.2) | 0.06 |
Tricuspid regurgitation | 28 (45.9) | 37 (22.6) | <0.01 |
Medical history. N (%) | |||
Smoking | 15 (24.6) | 60 (36.6) | 0.09 |
Diabetes mellitus | 13 (21.3) | 65 (39.6) | 0.01 |
BMI > 25 kg/m2 | 13 (26.0) | 76 (46.3) | 0.01 |
Hypertension | 36 (59.0) | 129 (78.7) | <0.01 |
COPD | 11 (18.0) | 7 (4.3) | <0.01 |
Atrial fibrillation | 14 (23.0) | 36 (22.0) | 0.87 |
Coronary artery disease | 12 (19.7) | 137 (83.5) | <0.01 |
History of malignancy | 8 (13.1) | 11 (6.7) | 0.12 |
Drugs on admission. N (%) | |||
Beta-blocker | 18 (32.1) | 79(48.5) | 0.03 |
ACE inhibitor | 19 (33.9) | 63 (38.7) | 0.53 |
Aldosteron inhibitor | 1 (1.8) | 2 (1.2) | 1.00 |
ASS | 17 (30.4) | 74 (45.4) | 0.05 |
Therapeutic anticoagulation | 2 (3.6) | 16 (9.8) | 0.15 |
Drugs on discharge. N (%) | |||
Beta-blocker | 42 (68.9) | 131 (79.9) | 0.08 |
ACE inhibitor | 32(52.5) | 104 (63.4) | 0.14 |
Aldosteron inhibitor | 0 (0.0) | 5 (3.0) | 0.33 |
Aspirin | 26 (42.6) | 139 (84.8) | <0.01 |
Therapeutic anticoagulation | 16 (26.2) | 15 (9.1) | <0.01 |
Variables | TTS (n = 61) | MI (n = 164) | p Value * |
---|---|---|---|
Life-threatening arrhythmia | 9 (14.8) | 29 (17.7) | 0.60 |
NPPV and or intubation | 40 (65.6) | 24 (14.6) | <0.01 |
Inotropic agents | 15(24.6) | 26 (15.9) | 0.13 |
Resuscitation | 7(11.5) | 25 (15.2) | 0.47 |
ICD or pacemaker Implantation | 4 (6.6) | 44 (26.8) | <0.01 |
Admission to ICU. length of stay (IQR) | 6 (0–52) | 3 (0–31) | 0.02 |
In-hospital death | 6 (9.8) | 19 (11.6) | 0.71 |
Cardiogenic Shock | 17 (27.9) | 30 (18.3) | 0.12 |
Variables | TTS (n = 61) | MI (n = 164) | Relative Risk (95% CI) | p Value * |
---|---|---|---|---|
In-hospital mortality | 6 (9.8) | 19 (11.6) | 0.8 (0.4–2.0) | 0.71 |
30-day mortality | 5 (8.2) | 19 (11.6) | 0.7 (0.3–1.8) | 0.46 |
Long-term mortality | 23 (37.7) | 34 (20.7) | 1.8 (1.2–2.8) | 0.02 |
Cardiovascular cause of death | 7 (11.5) | 26 (15.9) | 0.7 (0.3–1.6) | 0.41 |
Non-cardiovascular cause of death | 12 (19.7) | 5 (3.0) | 6.5 (2.4–17.6) | <0.01 |
Unknown cause of death | 4 (6.6) | 4 (2.4) | 8.8 (1.0–73.5) | 0.22 |
30-day Stroke | 1 (1.6) | 1 (0.6) | 2.7 (0.2–42.3) | 0.47 |
1-year Stroke | 2 (3.3) | 1 (0.6) | 5.4 (0.5–58.2) | 0.18 |
Long-term Stroke | 5 (8.2) | 4 (2.4) | 3.4 (0.9–12.1) | 0.06 |
30-day life-threatening arrythmia | 8 (13.1) | 21 (12.8) | 1.0 (0.5–2.2) | 0.95 |
1-year life-threatening arrythmia | 8 (13.1) | 22 (13.4) | 1.0 (0.5–2.0) | 0.95 |
Long-term life-threatening arrythmia | 8 (13.1) | 36 (22.0) | 0.6 (0.3–1.2) | 0.14 |
30-day Heart Failure | 3 (4.9) | 27 (16.5) | 0.3 (0.1–0.9) | 0.02 |
1-year Heart Failure | 4 (6.6) | 33 (20.1) | 0.3 (0.1–0.9) | 0.02 |
Long-term Heart Failure | 5 (8.2) | 44 (26.8) | 0.3 (0.1–0.7) | <0.01 |
30-day Recurrence | 0 (0.0) | 1 (0.6) | 1.00 | |
1-year Recurrence | 0 (0.0) | 10 (6.1) | 0.07 | |
Long-term Recurrence | 3 (4.9) | 27 (16.5) | 0.3 (0.1–0.9) | 0.03 |
30-day Thromboembolic Events | 1 (1.6) | 0 (0.0) | 0.32 | |
1-year Thromboembolic Events | 1 (1.6) | 0 (0.0) | 0.27 | |
Long-term Thromboembolic Events | 2 (3.3) | 5 (3.0) | 1.0 (0.2–5.4) | 1.00 |
Multivariate Analysis for the End Point | ||||||
---|---|---|---|---|---|---|
Univariate Analysis | Multivariate Analysis | |||||
HR | 95%CI | p-Value | HR | 95%CI | p-Value | |
Male | 2.2 | 1.0–5.0 | 0.04 | 2.7 | 1.1–6.5 | 0.02 |
Age | 1.0 | 0.9–1.0 | 0.45 | |||
EF < 35% | 2.1 | 1.1–4.3 | 0.02 | 1.3 | 0.5–2.9 | 0.49 |
COPD | 1.1 | 0.4–2.4 | 0.85 | |||
GFR < 60 mL/min | 2.4 | 1.2–4.9 | 0.01 | 2.8 | 1.2–6.0 | 0.01 |
Cardiogenic shock | 4.6 | 2.2–9.3 | <0.01 | 2.7 | 0.6–11.8 | 0.18 |
Inotropic drugs | 3.9 | 1.9–7.8 | <0.01 | 1.25 | 0.2–6.1 | 0.77 |
DM Typ II | 1.0 | 0.4–2.2 | 0.97 | |||
Hypertension | 0.7 | 0.3–1.5 | 0.41 | |||
Apical ballooning | 1.8 | 0.7–4.3 | 0.18 | |||
History of cancer | 2.8 | 1.3–6.4 | <0.01 | 3.6 | 1.4–9.3 | <0.01 |
Smoking | 0.8 | 0.3–1.7 | 0.64 |
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Bill, V.; El-Battrawy, I.; Kummer, M.; Mügge, A.; Aweimer, A.; Behnes, M.; Akin, I. Kidney Failure among Patients with Takotsubo Syndrome or Myocardial Infarction: A Retrospective Analysis. J. Cardiovasc. Dev. Dis. 2022, 9, 186. https://doi.org/10.3390/jcdd9060186
Bill V, El-Battrawy I, Kummer M, Mügge A, Aweimer A, Behnes M, Akin I. Kidney Failure among Patients with Takotsubo Syndrome or Myocardial Infarction: A Retrospective Analysis. Journal of Cardiovascular Development and Disease. 2022; 9(6):186. https://doi.org/10.3390/jcdd9060186
Chicago/Turabian StyleBill, Verena, Ibrahim El-Battrawy, Marvin Kummer, Andreas Mügge, Assem Aweimer, Michael Behnes, and Ibrahim Akin. 2022. "Kidney Failure among Patients with Takotsubo Syndrome or Myocardial Infarction: A Retrospective Analysis" Journal of Cardiovascular Development and Disease 9, no. 6: 186. https://doi.org/10.3390/jcdd9060186