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Impact of new-onset Atrial Fibrillation on prognosis 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
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Introduction:</strong> Although recent studies suggest that AF is a poor outcome predictor in Takotsubo Syndrome (TTS), the association between new-onset AF during hospitalization and adverse events in TTS remains unclear. </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Purpose:</strong> This study aims to investigate the prevalence, clinical correlates, and prognostic impact of new-onset AF in TTS patients.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Methods:</strong> Consecutive patients admitted in our centre with TTS in the last 15 years were retrospectively evaluated. Patients with previous history of AF were excluded. Patients were categorized based on the presence or absence of new-onset AF during hospitalization. Baseline characteristics, clinical management and outcomes were compared between the two groups. Association between new-onset AF in TTS patients and major adverse cardiovascular and cerebrovascular events (MACCE), including death, cerebrovascular events, myocardial infarction, heart failure and recurrency, was analyzed using multivariate Cox regression model. </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Results:</strong> Of the 109 included patients, 12 (11.1%) developed new-onset AF. Patients with AF were less frequently female (66.7% vs 88.5%, p=0.039). There were no significant differences in age (76±10 vs 70±12, p=0.083) and preexisting comorbidities, except for arterial hypertension (91.7% vs 59.4%, p=0.03) between the 2 groups. Incidence of physical triggers (p=0,997) and typical form (p=0.686) were also similar and LVEF at admission was not significantly lower in AF group (38.4±11.3 vs 41.2±10.5%, p=0.401). </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">Patients with AF had longer hospital stays (5±4 vs 8±5 days, p=0.004), but there were no significant differences in in-hospital mortality (8.3% vs 2.1%, p=0.300) and complications between the 2 groups, including cerebrovascular events (8.3% vs 2.1% p=0.300). Prescribed medication during hospitalization and at discharge was similar, except for anticoagulant agents.</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">At discharge, LVEF showed no significant difference between groups (47.7+13.5% vs 52.6+10.9% p=0.068), but non-AF patients exhibited a higher incidence of LVEF recovery (59.5% vs 27.3%, p=0.044).</span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">In a multivariate regression analysis, after adjusting for possible confounders, new-onset AF was an independent predictor of MACCE (HR 2.97, 95% CI 1.124-7.861, p=0.028). </span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong>Conclusion:</strong> In our study, new-onset AF during TTS hospitalization was associated with higher incidence of MACCE, underscoring the prognostic significance of AF in TTS. The potential benefits of antiarrhythmics, cardioversion and catheter ablation in TTS patients with AF warrant investigation in future studies.</span></span></p>
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