Incidence and Clinical Impact of Recurrent Takotsubo Syndrome: Results From the GEIST Registry

Salvatore Novo, Giuseppina Novo, Ibrahim Akin, Ingo Eitel, Holger Thiele, Federico Guerra, Thomas Stiermaier, Francesco Santoro, Irene Giannini, Ibrahim El-Battrawy, Christian Möller, Francesca Guastafierro, Holger Thiele, Fabiana Romeo, Holger Thiele, Francesco Santoro, Francesco Santoro, Enrica Mariano, Francesco Romeo, Alessandro CapucciNatale Daniele Brunetti

Research output: Contribution to journalArticlepeer-review

46 Citations (Scopus)


Background: Current literature only reports variable information from single-center studies on the recurrence rate, the complications, and the outcome of patients with Takotsubo syndrome (TTS) experiencing recurrent TTS. Therefore, a detailed description of clinical characteristics, predictors, and the prognostic impact of patients with TTS and recurrences in a multicenter registry is needed. Methods and Results: We analyzed 749 patients with TTS from 9 European centers being part of the international, multicenter GEIST (German Italian Stress Cardiomyopathy) Registry. Patients were divided into the recurrence group and the nonrecurrence group. The recurrence rate at a median follow-up of 830 days (interquartile range, 118–1701 days) was 4%. Most recurrences were documented in the first 5 years after the index TTS episode. Up to 2 TTS recurrences were documented in 2 of 30 patients (6%). A variable ballooning pattern (n=6, 0.8%) with, in particular, involvement of the right ventricular occurred in 3 cases (0.4%) at the recurrence event. Except for the higher presence of arterial hypertension (86.7% versus 68.3%; P=0.03) in the recurrence group, no other baseline characteristics were different between groups. Observation of TTS complications during follow-up, including stroke, thromboembolic events, in-hospital death, and cardiogenic shock, revealed no significant differences between groups (P>0.05), except the higher presence of pulmonary edema in the recurrence group versus the nonrecurrence group (13.3% versus 4.9%; P=0.04). Conclusions: The incidence of TTS recurrence is estimated to be 4% in this multicenter TTS registry. A variable TTS pattern at recurrence is common in up to 20% of recurrence cases.
Original languageEnglish
Pages (from-to)e010753-
Number of pages7
Publication statusPublished - 2019

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine


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