Risk stratification using the CHA2DS2-VASc score in Takotsubo syndrome: Data from the Takotsubo Italian network

Giuseppina Novo, Corinna Armentano, Rodolfo Citro, Daniella Bovelli, Benedetta Bellandi, Giovanni Marinosci, Francesco Antonini-Canterin, Michele Santoro, Marco Mariano Patella, Francesco Rotondi, Giovanni Gregorio, Federico Nardi, Elisabetta Grolla, Guido Parodi, Eduardo Bossone, Fernando Scudiero, Marco Fabio Costantino, Costantina Prota, Angelo Silverio, Antonino CoppolaJorge Salerno-Uriarte, Chiara Zocchi, Alfredo Bianchi, Michele Pappalettera, Alfredo Bianchi, Andrea Pozzi, Fiore Manganelli, Fiore Manganelli, Fiore Manganelli, Fiore Manganelli, Fiore Manganelli, Pompea Bottiglieri, Amelia Ravera, Francesco Bovenzi, Concetta Zito, Ercole Tagliamonte, Fausto Rigo, Costantino Astarita, Federico Piscione, Carlo Di Mario, Marco Pascotto, Stefano Del Pace

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Abstract

Background--The CHA2DS2-VASc score predicts stroke in patients with atrial fibrillation and has been reported to have a prognostic role even in acute coronary syndrome patients. The Takotsubo syndrome is a condition that mimics acute coronary syndrome and may present several complications including stroke. We sought to assess the ability of CHA2DS2-VASc score to predict adverse events in Takotsubo syndrome patients. Methods and Results--Overall, 371 Takotsubo syndrome patients were enrolled in a prospective registry. Patients were divided into 3 groups according to the CHA2DS2-VASc score: Group A (≤1), B (2-3), and C (≥4). The median CHA2DS2-VASc score was 3 (interquartile range: 2-4). Overall, 9%, 42%, and 49% were included in Group A, B, and C, respectively. Follow-up length was 26±20 months. The mortality rate was 6%, 7%, and 17% in Group A, B, and C, respectively (P= 0.011). The stroke rate was 3% and not different among the 3 groups. Estimated major adverse cardiac and cerebrovascular events (the composite of death, myocardial infarction, and stroke) rates in the 3 groups were 6%, 9%, and 17% in Group A, B, and C, respectively (P=0.033). The CHA2DS2-VASc score resulted as a predictor of major adverse cardiac and cerebrovascular events (odds ratio 2.1, 95% confidence interval, 1.2-3.6; P=0.01) and all-cause mortality (odds ratio 1.5, 95% confidence interval, 1.2-1.9; P=0.001). Conclusions--In Takotsubo syndrome, the CHA2DS2-VASc score allows prediction of cardiovascular events and mortality at longterm follow-up.
Original languageEnglish
Number of pages7
JournalJOURNAL OF THE AMERICAN HEART ASSOCIATION. CARDIOVASCULAR AND CEREBROVASCULAR DISEASE
Volume6
Publication statusPublished - 2017

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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    Novo, G., Armentano, C., Citro, R., Bovelli, D., Bellandi, B., Marinosci, G., Antonini-Canterin, F., Santoro, M., Patella, M. M., Rotondi, F., Gregorio, G., Nardi, F., Grolla, E., Parodi, G., Bossone, E., Scudiero, F., Costantino, M. F., Prota, C., Silverio, A., ... Del Pace, S. (2017). Risk stratification using the CHA2DS2-VASc score in Takotsubo syndrome: Data from the Takotsubo Italian network. JOURNAL OF THE AMERICAN HEART ASSOCIATION. CARDIOVASCULAR AND CEREBROVASCULAR DISEASE, 6.