Renal impairment and outcome in patients with takotsubo cardiomyopathy

详细信息    查看全文

• 作者：Francesco Santoro ; MD^a ; Armando Ferraretti ; MD^a ; Riccardo Ieva ; MD^a ; Francesco Musaico ; MD^a ; Mario Fanelli ; MD^a ; Nicola Tarantino ; MD^a ; Maria Scarcia ; MD^a ; Pasquale Caldarola ; MD^b ; Matteo Di Biase ; MD^a ; Natale Daniele Brunetti ; MD ; PhD^a ; ^{natale.brunetti@unifg.it" class="auth_mail" title="E-mail the corresponding author}
• 刊名：The American Journal of Emergency Medicine
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：34
• 期：3
• 页码：548-552
• 全文大小：354 K

文摘

The objectives were to ascertain the prevalence of renal impairment among patients with a takotsubo cardiomyopathy (TTC) episode and whether clinical outcomes are related to renal function.

Methods

A total of 108 consecutive subjects with TTC were enrolled in a multicenter registry and followed for a mean period of 429 days. Renal function was evaluated during hospitalization in terms of acute kidney injury/failure and estimated glomerular filtration rate (eGFR). Incidence of death, rehospitalization, and recurrence of TTC during follow-up was recorded.

Results

Raised creatinine levels can be found during hospitalizations for TTC episodes (analysis of variance P < .001). Incidence of acute kidney injury was 10%; that of acute kidney failure was 1%. Admission eGFR levels were proportional to the duration of hospitalization (r = − 0.28, P < .01). Estimated GFR nadir values were related to adverse events at follow-up (log-rank P < .001). The hazard ratio of adverse events at follow-up in subjects with severe renal impairment (nadir eGFR < 30 mL/[min 1.73 m²]) vs those with eGFR > 60 mL/(min 1.73 m²) was 1.817 (95% confidence interval, 1.097-3.009; P < .05).

Conclusions

Raised creatinine levels and impaired renal function may be found in patients with TTC. Lower eGFR values during hospitalization are associated with longer hospitalizations and higher rates of adverse events at follow-up. Renal function during a TTC episode should be carefully evaluated.