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Risk Stratification Using the CHA2DS2-VASc Score in Takotsubo Syndrome: Data From the Takotsubo Italian Network
Guido Parodi1,2, Fernando Scudiero3, Rodolfo Citro4
1Cardiovascular and Thoracic Department, Careggi University Hospital, Florence, Italy parodiguido@gmail.com.
Insights
The CHA2DS2-VASc score can predict major adverse cardiovascular and cerebrovascular events and mortality in patients with Takotsubo syndrome. This score helps assess long-term risks for these patients.
Area of Science:
- Cardiology
- Clinical Risk Stratification
Background:
- The CHA2DS2-VASc score is established for predicting stroke in atrial fibrillation patients.
- It also shows prognostic value in acute coronary syndrome.
- Takotsubo syndrome, mimicking acute coronary syndrome, can lead to complications like stroke.
Purpose of the Study:
- To evaluate the predictive ability of the CHA2DS2-VASc score for adverse events in Takotsubo syndrome patients.
- To assess the score's role in stratifying risk for mortality and major adverse cardiac and cerebrovascular events.
Main Methods:
- A prospective registry of 371 Takotsubo syndrome patients was analyzed.
- Patients were stratified into three groups based on CHA2DS2-VASc score: Group A (≤1), Group B (2-3), and Group C (≥4).
- Outcomes including mortality, myocardial infarction, and stroke were tracked over a median follow-up of 26 months.
Main Results:
- The CHA2DS2-VASc score predicted major adverse cardiac and cerebrovascular events (odds ratio 2.1) and all-cause mortality (odds ratio 1.5).
- Higher CHA2DS2-VASc scores correlated with increased mortality rates (6% in Group A, 7% in B, 17% in C; P=0.011).
- Rates of major adverse cardiac and cerebrovascular events also increased with score (6% in A, 9% in B, 17% in C; P=0.033).
Conclusions:
- The CHA2DS2-VASc score effectively predicts cardiovascular events and mortality in Takotsubo syndrome patients.
- This score serves as a valuable tool for long-term risk assessment in this population.
Background:
The CHA2DS2-VASc score predicts stroke in patients with atrial fibrillation and has been reported to have a prognostic role even in acute coronary syndrome patients. The Takotsubo syndrome is a condition that mimics acute coronary syndrome and may present several complications including stroke. We sought to assess the ability of CHA2DS2-VASc score to predict adverse events in Takotsubo syndrome patients.
Methods And Results:
Overall, 371 Takotsubo syndrome patients were enrolled in a prospective registry. Patients were divided into 3 groups according to the CHA2DS2-VASc score: Group A (≤1), B (2-3), and C (≥4). The median CHA2DS2-VASc score was 3 (interquartile range: 2-4). Overall, 9%, 42%, and 49% were included in Group A, B, and C, respectively. Follow-up length was 26±20 months. The mortality rate was 6%, 7%, and 17% in Group A, B, and C, respectively (P=0.011). The stroke rate was 3% and not different among the 3 groups. Estimated major adverse cardiac and cerebrovascular events (the composite of death, myocardial infarction, and stroke) rates in the 3 groups were 6%, 9%, and 17% in Group A, B, and C, respectively (P=0.033). The CHA2DS2-VASc score resulted as a predictor of major adverse cardiac and cerebrovascular events (odds ratio 2.1, 95% confidence interval, 1.2-3.6; P=0.01) and all-cause mortality (odds ratio 1.5, 95% confidence interval, 1.2-1.9; P=0.001).
Conclusions:
In Takotsubo syndrome, the CHA2DS2-VASc score allows prediction of cardiovascular events and mortality at long-term follow-up.