Takotsubo Multicenter Registry (REMUTA) - Clinical Aspects, In-Hospital Outcomes, and Long-Term Mortality

Gustavo Luiz Gouvêa de Almeida Junior, João Mansur Filho, Denilson Campos de Albuquerque, Sergio Salles Xavier, Álvaro Pontes, Elias Pimentel Gouvêa, Alexandre Bahia Barreiras Martins, Nágela S V Nunes, Lilian Vieira Carestiato, João Luiz Fernandes Petriz, Armando Márcio Gonçalves Santos, Bruno Santana Bandeira, Bárbara Elaine de Jesus Abufaiad, Luciana da Camara Pacheco, Maurício Sales de Oliveira, Paulo Eduardo Campana Ribeiro Filho, Pedro Paulo Nogueres Sampaio, Gustavo Salgado Duque, Luiz Felipe Camillis, André Casarsa Marques, Francisco Carlos Lourenço, José Ricardo Palazzo, Cláudio Ramos da Costa, Bibiana Almeida da Silva, Cleverson Neves Zukowski, Romulo Ribeiro Garcia, Fernanda de Carvalho Zonis, Suzana Andressa Morais de Paula, Carolina Gravano Ferraz Ferrari, Bruno Soares da Silva Rangel, Roberto Muniz Ferreira, Bárbara Ferreira da Silva Mendes, Isabela Ribeiro Carvalho de Castro, Leonardo Giglio Gonçalves de Souza, Luiz Henrique Dos Santos Araújo, Alexandre Giani
Arquivos Brasileiros de Cardiologia 2020 August 28, 115 (2): 207-216

BACKGROUND: Takotsubo syndrome (TTS) is an acquired form of cardiomyopathy. National Brazilian data on this condition are scarce. The Takotsubo Multicenter Registry (REMUTA) is the first to include multicenter data on this condition in Brazil.

OBJECTIVE: To describe the clinical characteristics, prognosis, in-hospital treatment, in-hospital mortality, and mortality during 1 year of follow-up.

METHODS: This is an observational, retrospective registry study including patients admitted to the hospital with diagnosis of TTS and patients admitted for other reasons who developed this condition. Evaluated outcomes included triggering factor, analysis of exams, use of medications, complications, in-hospital mortality, and mortality during 1 year of follow-up. A significance level of 5% was adopted.

RESULTS: The registry included 169 patients from 12 centers in the state of Rio de Janeiro, Brazil. Mean age was 70.9 ± 14.1 years, and 90.5% of patients were female; 63% of cases were primary TTS, and 37% were secondary. Troponin I was positive in 92.5% of patients, and median BNP was 395 (176.5; 1725). ST-segment elevation was present in 28% of patients. Median left ventricular ejection fraction was 40 (35; 48)%. We observed invasive mechanical ventilation in 25.7% of cases and shock in 17.4%. Mechanical circulatory support was used in 7.7%. In-hospital mortality was 10.6%, and mortality at 1 year of follow-up was 16.5%. Secondary TTS and cardiogenic shock were independent predictors of mortality.

CONCLUSION: The results of the REMUTA show that TTS is not a benign pathology, as was once thought, especially regarding the secondary TTS group, which has a high rate of complications and mortality. (Arq Bras Cardiol. 2020; 115(2):207-216).

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