SPC365

InterTAK Prognostic Score – A useful tool to predict mortality in Takotsubo Syndrome?

Session: Sessão de Posters 32 - MINOCA
Speaker: Isabel Maria Martins Moreira

Congress: CPC 2024
Topic: E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
Theme: 13. Acute Coronary Syndromes
Subtheme: 13.7 Acute Coronary Syndromes - Other
Session Type: Cartazes
FP Number: ---
Authors: Isabel Martins Moreira; Catarina Ribeiro Carvalho; Marta Catarina Bernardo; Luís Sousa Azevedo; Pedro Rocha Carvalho; Pedro Magalhães; Catarina Ferreira; Inês Silveira; Ilídio Moreira

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:12.0pt">Introduction: </span></strong><span style="font-size:12.0pt">InterTAK Prognostic Score (ITPS)</span> <span style="font-size:12.0pt">is a risk stratification score designed to predict short- and long-term mortality in Takotsubo syndrome (TTS) patients. However, there are no papers regarding its external validation.</span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:12.0pt">Purpose: </span></strong><span style="font-size:12.0pt">To test the applicability of ITPS in predicting in-hospital and long-term mortality in a different cohort of TTS patients. </span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:12.0pt">Methods:</span></strong> <span style="font-size:12.0pt">We performed a retrospective analysis of patients admitted with TTS in our centre in the last 15 years. </span><span style="font-size:12.0pt">Patients&rsquo; baseline characteristics, clinical management and outcome data were collected. ITPS at hospital admission was calculated using the sum of the following parameters: age &gt;70 years (8 points), </span><span style="font-size:12.0pt">male sex (6 points), </span><span style="font-size:12.0pt">diabetes mellitus (6 points), systolic blood pressure (SBP) &lt;119mmHg (7 points), heart rate (HR) &gt;94bpm (4 points), triggering factors (secondary to neurologic disorders &ndash; 15 points; </span></span></span><span style="font-size:12.0pt"><span style="font-family:&quot;Calibri&quot;,sans-serif">physical trigger, medical condition&nbsp;or procedure&nbsp;</span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:12.0pt">&ndash; 9 points; no identifiable trigger &ndash; 3 points) and left ventricular ejection fraction (LVEF) </span><span style="font-size:12.0pt">&le;45% (6 points)</span><span style="font-size:12.0pt">. The score&rsquo;s capacity to predict in-hospital and long-term mortality was analysed using ROC curves and their respective area under the curve (AUC). </span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:12.0pt">Results:</span></strong><span style="font-size:12.0pt"> A total of 121 patients (86% females, mean age of 71&plusmn;12years) were included in our study. Overall, 84.9% of patients presented with typical TTS type and mean LVEF at admission was 41.5&plusmn;10.7%. Mean SBP and HR on admission were 130&plusmn;27mmHg and 82&plusmn;18bpm. The prevalence of diabetes mellitus and neurologic disorder was 26.4% and 12.4%, respectively. An emotional trigger was identified in 32.2% of TTS patients, while 33.9% had a preceding physical trigger and the remaining patients (33.9%) had no identifiable triggering factors. In-hospital mortality rate was 3.3% and 1-year follow-up mortality was 4.9%.</span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:12.0pt">In ROC curve analysis, ITPS exhibited an acceptable predictive power for in-hospital mortality (AUC: 0.773, p=0.044 and 95% IC 0.627-0.919) and an excellent predictive power for 1-year mortality in TTS population (AUC: 0.909, p=0.006, 95% IC 0.838-0.980). The optimal ITPS cut-off in our study was 21.5 (85.7% sensitivity and 61.8% specificity).&nbsp;</span></span></span><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><span style="font-size:12.0pt">Using a Kaplan-Meyer survival analysis, mortality was significantly higher in patients with InterTAK prognostic score &ge;21.5 (log-rank p=0.010).</span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:12.0pt">Conclusion:</span></strong><span style="font-size:12.0pt"> In our study, ITPS displayed excellent predictive power for 1-year mortality in TTS patients and acceptable predictive power for in-hospital mortality. Further studies are needed to establish ITPS as a widespread risk stratification score.</span></span></span></p>