Outcomes of catecholamine and/or mechanical support in Takotsubo syndrome.

• Material Type: 博士論文
• Title: Outcomes of catecholamine and/or mechanical support in Takotsubo syndrome.
• Author/Editor: Terasaki, Satoshi; Kanaoka, Koshiro; Nakai, Michikazu; Sumita, Yoko; Onoue, Kenji; Soeda, Tsunenari; Watanabe, Makoto; Miyamoto, Yoshihiro; Saito, Yoshihiko
• Author Heading: Terasaki, Satoshi; Kanaoka, Koshiro; Nakai, Michikazu; Sumita, Yoko; Onoue, Kenji; Soeda, Tsunenari; Watanabe, Makoto; Miyamoto, Yoshihiro; Saito, Yoshihiko
• Publication, Distribution, etc.: BMJ
• Publication Date: 2022-01-19
• Publication Date (W3CDTF): 2022-01-19
• Alternative Title: たこつぼ症候群におけるカテコラミンと機械的サポートの効果
• Periodical title: Heart
• No. or year of volume/issue: 108 18
• Volume: 108
• Issue: 18
• Pages: 1467-1473
• ISSN (Periodical Title): ISSN : 1355-6037
• Degree grantor/type: 奈良県立医科大学
• Date Granted: 2022-03-15
• Dissertation Number: 甲第822号
• Degree Type: 博士（医学）
• Text Language Code: eng
• Target Audience: 一般
• Note (General): type:Thesis; Objective: This study aimed to reveal the clinical characteristics of patients with severe Takotsubo syndrome (TTS) who needed catecholamine support (CS) or mechanical support (MS) and to identify factors associated with serious illness and in-hospital mortality. Methods: This was a nationwide retrospective study that used claims data from the Japanese registry of all cardiac and vascular diseases and the diagnosis procedure combination registry, from April 2012 to March 2016. The patients with TTS were divided into severe TTS and mild TTS groups. The severe group was defined as patients who needed CS and/or MS. Results: Among 6169 patients with TTS, 1148 (18.6%) had severe TTS. No significant difference in age was found between the two groups; however, the number of female patients was significantly lower in the severe group than in the mild group. Among 130 patients who underwent MS, 22 and 108 patients required MS alone and both MS and CS, respectively. The 30-day mortality rate was significantly higher in the severe group than in the mild group (11.4% vs 2.6%, p<0.01) and increased with age. Of the patients with severe TTS, 65.6% died within 7 days. Multivariable analysis showed that male sex (OR 1.22, p=0.03), higher Charlson scores (OR 1.11, p<0.01), comorbid pneumonia (OR 1.68, p<0.01), comorbid sepsis (OR 6.02, p<0.01) and ambulance use (OR 2.01, p<0.01) were associated with severe TTS. Conclusions: The rate of severe TTS was 18.6% among 6169 patients registered in the Japanese nationwide database, and the 30-day mortality was higher in patients with severe TTS than in those with mild TTS (11.4% vs 2.6%).; 博士（医学）・甲第822号・令和4年3月15日; © Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.; This article has been accepted for publication in Heart, 2022 following peer review, and the Version of Record can be accessed online at http://dx.doi.org/10.1136/heartjnl-2021-319904.; identifier:Heart Vol.108 No.18 p.1467-1473 (2022 Sep); identifier:13556037; identifier:http://ginmu.naramed-u.ac.jp/dspace/handle/10564/4005; identifier:Heart, 108(18): 1467-1473
• Access Restrictions: インターネット公開
• Related Material (DOI): 10.1136/heartjnl-2021-319904
• Data Provider (Database): 国立情報学研究所 : 学術機関リポジトリデータベース（IRDB）（機関リポジトリ）; https://irdb.nii.ac.jp
• Original Data Provider (Database): 奈良県立医科大学 : 奈良県立医科大学機関リポジトリ GINMU

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