Heart failure & cardiomyopathiesMeta-analysis
Prognostic Value of Microvascular Function in Takotsubo Syndrome
- Pooled analysis of individual patient data from prospective cohorts
- collaborative
Authors' conclusion
In this pooled analysis of individual patient data from 9 prospective TTS cohorts, microvascular dysfunction measured in the acute phase was associated with all-cause mortality. In particular, an elevated microvascular resistance, as assessed by IMR, was the only independent predictor of both mortality and MACCE.
Study context
- Population
- Patients with Takotsubo syndrome with invasive assessment of coronary microvascular function (index of microcirculatory resistance (IMR), coronary flow reserve, microvascular resistance reserve) in the acute phase
- Participants
- 166 patients · 9 prospective cohorts
- Comparison
- Typical TTS vs Atypical TTS
- Typical (apical) TTSn = 130
- Atypical TTSn = 36
- Outcome
- All-cause mortality
- Follow-up
- Median 20.6 [4.3-60.0] months
Pooled result
As reported in the abstract
Adjusted hazard ratio
3.9
95% CI 1.39–10.88
P = 0.010
IMR
aHR 3.9 (95% CI 1.39–10.88); P = 0.010
- All-cause mortality events
- 17 patients (10.2%)
Further pooled results
Major adverse cardiac and cerebrovascular events (MACCE) (all-cause death, TTS recurrence, stroke, TIA or MI) · median follow-up 20.6 [4.3-60.0] months
| Comparison | aHR (95% CI) | P value | |
|---|---|---|---|
| IMR | 2.6 (1.17–5.67) | P = 0.018 | |
| 0.20.5125Adjusted hazard ratio (log scale) |
- MACCE (all-cause death, TTS recurrence, stroke, TIA or MI) — MACCE events
- 29 patients (17.5%)
- MACCE (all-cause death, TTS recurrence, stroke, TIA or MI): c-statistic 0.719 (95% CI 0.612-0.826); only independent predictor after adjustment
Original publication
Prognostic Value of Microvascular Function in Takotsubo Syndrome. JACC Cardiovasc Interv. Published 22 May 2025. doi:10.1016/j.jcin.2025.05.028
Summarised from the published abstract; every number is checked against it