Left Ventricular Thrombi in Takotsubo Syndrome: Incidence, Predictors, and Management: Results From the GEIST (German Italian Stress Cardiomyopathy) Registry

• DOI: 10.1161/jaha.117.006990
• Publication Date: 2017-12-05T01:10:28Z
• Authors: Francesco Santoro; Thomas Stiermaier; Nicola Tarantino; Luisa De Gennaro; Christian Moeller; Francesca Guastaf...; Maria Francesca M...; Roberta Montisci; Elena Carapelle; Tobias Graf; Pasquale Caldarola; Holger Thiele; Matteo Di Biase; Natale Daniele Br...; Ingo Eitel
• Keywords: Stroke

Background Left ventricular ( LV ) thrombi during Takotsubo syndrome represent a potential complication and can be associated with cerebrovascular embolic events. The aim of this study was to evaluate the exact incidence, predictors, management strategies in patients syndrome. Methods Results We enrolled 541 consecutive multicenter international registry. Clinical features echocardiographic data at admission, hospitalization, after 3 months were evaluated. Survival rates for long‐term follow‐up (mean 984±908 days) recorded. Twelve (2.2%) developed (all female presenting apical ballooning pattern). All treated oral anticoagulation therapy; however, 2 (17%) had stroke before treatment initiation. These characterized by higher prevalence ST ‐elevation (56% versus 16%; P <0.001) troponin I levels (10.8±18.3 ng/mL 3.5±4.3 ng/mL; =0.001) as compared those without thrombi. At multivariate analysis including age, sex, ejection fraction, pattern, level >10 only predictor thrombosis (hazard ratio 6.6, confidence interval, 1.01–40.0; =0.04). After all disappeared. Oral therapy interrupted except 1. follow‐up, survival rate not different between (84% 85%; =0.99). Conclusions have relatively low incidence among detected pattern increased levels. seems reasonable these high‐risk patients.