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C-Reactive Protein Can Predict Outcomes in Patients With Takotsubo Syndrome
Gassan Moady1,2, BateL Yelin2, Rania Sweid3
1Department of Cardiology, Galilee Medical Center, Nahariya, Israel.
Insights
C-reactive protein (CRP) levels correlate with reduced left ventricular ejection fraction (LVEF) and longer hospital stays in Takotsubo syndrome (TTS) patients. Poor LVEF is also linked to TTS recurrence, highlighting CRP as a potential prognostic marker.
Area of Science:
- Cardiology
- Biomarkers
- Cardiomyopathy
Background:
- Takotsubo syndrome (TTS) is a reversible cardiomyopathy primarily affecting elderly women, often triggered by stressors.
- Inflammatory and cardiac biomarkers play a role in TTS pathogenesis.
- The prognostic significance of C-reactive protein (CRP) in TTS requires further investigation.
Purpose of the Study:
- To investigate the correlation between C-reactive protein (CRP) levels and left ventricular ejection fraction (LVEF) in patients diagnosed with Takotsubo syndrome (TTS).
- To examine the relationship between CRP levels and clinical outcomes, including length of stay (LOS), in-hospital complications, and recurrence in TTS patients.
Main Methods:
- Retrospective analysis of 86 patients diagnosed with Takotsubo syndrome between 2017 and 2022.
- Data collected included demographic, laboratory (CRP), echocardiographic (LVEF), and clinical outcome information.
- Statistical analyses, including correlation, logistic regression, and linear regression, were used to assess relationships between CRP, LVEF, and clinical outcomes.
Main Results:
- CRP levels were significantly associated with lower LVEF (r=-0.39, p<0.001) and longer hospital stays (r=0.25, p=0.021).
- No significant correlation was found between CRP levels and in-hospital complications.
- Poor LVEF was independently associated with TTS recurrence (OR, 1.22; p=0.001).
Conclusions:
- Elevated CRP levels in TTS patients are associated with impaired left ventricular function and prolonged hospitalization.
- While CRP did not correlate with in-hospital complications, its association with LVEF and LOS suggests a role in disease severity.
- Left ventricular ejection fraction is a significant predictor of Takotsubo syndrome recurrence.
Background And Objectives:
Takotsubo syndrome (TTS) is a form of reversible cardiomyopathy often preceded by mental or physical stressors and predominantly affects elderly women. Several cardiac and inflammatory biomarkers are involved in the pathogenesis of the disease. We aimed to investigate the correlation of C-reactive protein (CRP) level with left ventricular ejection fraction (LVEF) and clinical outcomes in patients with TTS.
Methods:
The study included patients with discharge-diagnosis of Takotsubo through 2017-2022 from the cardiology department. Demographic, laboratory, echocardiographic, and clinical outcomes were retrospectively obtained. We investigated the relation between CRP and LVEF, length of stay (LOS), in-hospital complications, and recurrence.
Results:
A total of 86 patients (93% female, mean age 68.8±12.3 years) were included in the study. The median CRP level was 17.4 (interquartile range [IQR], 6.1-40.1) mg/L, and the mean LVEF was 41.5%, (IQR, 38-50%). Complications occurred in 24 (27.9%) of the patients, and the median LOS was 3 (IQR, 3-5) days. The level of CRP was associated with lower LVEF (r=-0.39, p<0.001), longer hospital stay (r=0.25, p=0.021), and recurrence. There was no correlation between CRP and in-hospital complications. In multivariate logistic regression, poor LVEF was associated with TTS recurrence (odds ratio, 1.22; 95% confidence interval, 1.08-1.37; p=0.001). Using linear regression, only CRP was correlated with longer LOS and lower LVEF (p<0.001).
Conclusions:
Among patients hospitalized with TTS, CRP level was associated with poor LVEF and prolonged hospital stay but not with in-hospital complications. Poor LVEF was also associated with TTS recurrence.
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