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Heart Failure Reviews

, Volume 24, Issue 4, pp 481–488 | Cite as

Malignancies and outcome in Takotsubo syndrome: a meta-analysis study on cancer and stress cardiomyopathy

  • Natale Daniele BrunettiEmail author
  • Nicola Tarantino
  • Francesca Guastafierro
  • Luisa De Gennaro
  • Michele Correale
  • Thomas Stiermaier
  • Christian Möller
  • Matteo Di Biase
  • Ingo Eitel
  • Francesco Santoro
Article
  • 219 Downloads

Abstract

Takotsubo syndrome (TTS) can be induced by a large variety of physical/emotional triggers; several cases, however, are related to either an overt or occult malignancy, as shown in retrospective studies and case reports. The aim of this study was therefore to evaluate the clinical outcome of patients with TTS and cancer in a meta-analysis study. In June 2018, a Pubmed systematic research was conducted for studies assessing outcome in patients with TTS and cancer. We assessed Mantel-Haenszel pooled estimates of risk ratios (RRs) and 95% confidence intervals (CIs) for adverse events at follow-up. After paper retrieval, four studies were included in the meta-analysis, with a total of 123,563 patients. The prevalence of current or previous malignancy among patients admitted with TTS was 6.7% (8258 patients). When compared to control patients, patients with cancer showed an increased risk of clinical events (RR 3.24, 95% CI 3.04–3.45, p < 0.01). The risk of in-hospital events was significantly higher in the cancer group (RR 2.08 95% CI, 1.50–2.87, p < 0.01) and was mainly due to higher need for respiratory support (RR 1.67, 95% CI, 1.58–1.77, p < 0.01). The risk of adverse events at follow-up was also higher in the cancer group (RR 3.30, 95% CI 3.09–3.51, p < 0.01). Cancer, either history or active, is associated with an increased risk of adverse events in TTS.

Keywords

Cancer Takotsubo syndrome Malignancy Prognosis Meta-analysis Stress cardiomyopathy 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

10741_2019_9773_MOESM1_ESM.docx (80 kb)
ESM 1 (DOCX 80 kb)

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Natale Daniele Brunetti
    • 1
    Email author
  • Nicola Tarantino
    • 1
  • Francesca Guastafierro
    • 1
  • Luisa De Gennaro
    • 2
  • Michele Correale
    • 1
    • 3
  • Thomas Stiermaier
    • 4
  • Christian Möller
    • 4
  • Matteo Di Biase
    • 5
  • Ingo Eitel
    • 4
  • Francesco Santoro
    • 1
    • 6
  1. 1.Department of Medical and Surgery SciencesUniversity of FoggiaFoggiaItaly
  2. 2.Cardiology DepartmentSan Paolo HospitalBariItaly
  3. 3.Ospedali Riuniti University HospitalFoggiaItaly
  4. 4.Medical Clinic II (Cardiology/Angiology/Intensive Care Medicine) and German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/LübeckUniversity Heart Center LübeckLübeckGermany
  5. 5.GVM Care and ResearchSanta Maria HospitalBariItaly
  6. 6.Department of CardiologyOspedale Bonomo HospitalAndriaItaly

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