Age-related differences in cardiogenic shock secondary to Takotsubo syndrome
Por:
Tomasino, M, Vazirani, R, Salamanca, J, Raposeiras-Roubin, S, Fernández-Cordón, C, Corbí-Pascual, M, Vedia, O, Martín-García, AC, Blanco-Ponce, E, Delia, MA, Piserra-López, A, Guerra, JFL, Gonzalez-Santorum, F, Lluch-Requerey, C, Guillén-Marzo, M, Pérez-Castellanos, A, Ridocci-Soriano, F, Lopez-País, J, Andrea, R, Sionis, A, Núñez-Gil, IJ, Uribarri, A
Publicada:
17 ene 2026
Ahead of Print:
1 sep 2025
Resumen:
Background Age-related differences in Takotsubo Syndrome (TTS) have been described, but there is limited information regarding TTS patients who develop cardiogenic shock (CS).Methods and Results We analysed data from 408 CS-TTS patients in the RETAKO registry. Patients were stratified into three age groups: <= 50 years (9%), 51-74 years (48%), and >= 75 years (43%). In the youngest group, compared to the middle-aged and the oldest groups, patients were more likely to be male (35% vs. 16% and 14%, p = .01), have a physical trigger (65% vs. 43% and 49%, p = .04), exhibit atypical echocardiographic patterns (27% vs. 11% and 11%, p = .02), and experienced a higher incidence of ventricular arrhythmias (24% vs. 8% and 7%, p = .01). In-hospital mortality rates were 5% in younger patients, 12% in middle-aged patients, and 15% in older patients (p = .15). Older age independently predicted both in-hospital mortality (OR 2.33, 95% CI 1.05-5.17; reference: middle-aged) and 5-year mortality (HR 3.69, 95% CI 1.77-7.67), regardless of shock severity.Conclusions In CS-TTS, younger patients exhibit distinct clinical features but have better outcomes. Older age is associated with higher in-hospital and long-term mortality, regardless of comorbidities and shock severity. These findings underscore the need for age-specific management strategies and further research into the mechanisms underlying age-related differences in CS-TTS.
Filiaciones:
Tomasino, M:
Univ Autonoma Barcelona UAB, Dept Med, Barcelona, Spain
Hosp Univ Vall dHebron, Dept Cardiol, Barcelona, Spain
Vall dHebron Inst Recerca VHIR, Barcelona, Spain
Vazirani, R:
Hosp Clin San Carlos, Dept Cardiol, Madrid, Spain
Salamanca, J:
Hosp Univ La Princesa, Inst Invest Sanitaria Princesa IIS IP, Dept Cardiol, Madrid, Spain
Raposeiras-Roubin, S:
Hosp Alvaro Cunqueiro, Dept Cardiol, Vigo, Spain
Fernández-Cordón, C:
Hosp Univ Valladolid, Dept Cardiol, Valladolid, Spain
Corbí-Pascual, M:
Hosp Univ Albacete, Dept Cardiol, Albacete, Spain
Vedia, O:
Hosp Univ Torrejon, Dept Cardiol, Madrid, Spain
Martín-García, AC:
Complejo Asistencial Univ Salamanca, Dept Cardiol, Salamanca, Spain
CIBER CV, Madrid, Spain
Blanco-Ponce, E:
Hosp Univ Arnau Vilanova IRB LLeida, Dept Cardiol, Lleida, Spain
Delia, MA:
Hosp Virgen Macarena, Dept Cardiol, Seville, Spain
Piserra-López, A:
CIBER CV, Madrid, Spain
Hosp Univ Virgen Victoria & IBIMA, Dept Cardiol, Malaga, Spain
Guerra, JFL:
Hosp Univ Fdn Jimenez Diaz, Dept Cardiol, Madrid, Spain
Gonzalez-Santorum, F:
Univ Autonoma Barcelona UAB, Dept Med, Barcelona, Spain
Vall dHebron Inst Recerca VHIR, Barcelona, Spain
Lluch-Requerey, C:
Hosp Univ Juan Ramon Jimenez, Dept Cardiol, Huelva, Spain
Guillén-Marzo, M:
Hosp Univ Tarragona Joan XXIII, Dept Cardiol, Tarragona, Spain
Pérez-Castellanos, A:
Hosp Univ Son Espases, Dept Cardiol, Palma De Mallorca, Spain
Ridocci-Soriano, F:
Consorcio Hosp Gen Univ Valencia, Dept Cardiol, Valencia, Spain
Lopez-País, J:
Hosp Univ Santiago, Dept Cardiol, Santiago De Compostela, Spain
Andrea, R:
Hosp Clin Barcelona, Dept Cardiol, Barcelona, Spain
Univ Barcelona IDIBAPS, Barcelona, Spain
Sionis, A:
CIBER CV, Madrid, Spain
Hosp Santa Creu i Sant Pau, Dept Pathol, Barcelona, Spain
Núñez-Gil, IJ:
Hosp Clin San Carlos, Dept Cardiol, Madrid, Spain
Hosp Univ Torrejon, Dept Cardiol, Madrid, Spain
Univ Europea Madrid, Fac Biomed & Hlth Sci, Villaviciosa De Odon, Spain
Uribarri, A:
Univ Autonoma Barcelona UAB, Dept Med, Barcelona, Spain
Hosp Univ Vall dHebron, Dept Cardiol, Barcelona, Spain
Vall dHebron Inst Recerca VHIR, Barcelona, Spain
CIBER CV, Madrid, Spain
Green Submitted, hybrid
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