In order to bring you the best possible user experience, this site uses Javascript. If you are seeing this message, it is likely that the Javascript option in your browser is disabled. For optimal viewing of this site, please ensure that Javascript is enabled for your browser.

The free consultation period for this content is over.

It is now only available year-round to ESC Professional Members, Fellows of the ESC, and Young combined Members

Takotsubo syndrome in patients with malignancies: a metanalysis.

Session Cardiovascular events in malignancies: from prediction to prevention

Speaker Francesco Santoro

Event : ESC Congress 2018

  • Topic : cardiovascular disease in special populations
  • Sub-topic : Cardio-Oncology
  • Session type : Rapid Fire Abstracts

Authors : N Tarantino (Foggia,IT), F Santoro (Hamburg,DE), F Guastafierro (Foggia,IT), V Di Terlizzi (Foggia,IT), SE Formica (Foggia,IT), R Ieva (Foggia,IT), G D'arienzo (Foggia,IT), PL Pellegrino (Foggia,IT), LC Ziccardi (Foggia,IT), M Di Biase (Foggia,IT), ND Brunetti (Foggia,IT)

N. Tarantino1 , F. Santoro2 , F. Guastafierro1 , V. Di Terlizzi1 , S.E. Formica1 , R. Ieva1 , G. D'Arienzo1 , P.L. Pellegrino1 , L.C. Ziccardi1 , M. Di Biase1 , N.D. Brunetti1 , 1University of Foggia, Department of Medical and Surgical Sciences - Foggia - Italy , 2Asklepios Clinic St. Georg - Hamburg - Germany ,

European Heart Journal ( 2018 ) 39 ( Supplement ), 1271

Background: Takotsubo syndrome (TTS) can be caused by a large variety of psycho-physical triggers, and several cases are related to either an overt or occult malignancy, as shown in retrospective studies and single reports.

Purpose: To evaluate the overall prevalence of cancer in takotsubo patients and to compare clinical outcomes with cancer-free takotsubo subjects in a metanalysis study.

Methods: In December 2017 a Pubmed and ResearchGate systematic screening was conducted for retrospective studies concerning this topic. Works with no comparison group were excluded. Outocomes of interest were in-hospital events (life threatening arrhythmias, cardiogenic shock, thromboembolism, respiratory support) and events at follow-up (all-cause mortality, re-hospitalization for cardiovascular disease) assessed with Mantel-Haenszel pooled risk ratios (RRs) and 95% confidence intervals (CIs). Furthermore, an analysis of the most frequent occurred neoplasms as well as the time to the diagnosis after the index event was performed.

Results: Three studies were included with a total of 554 patients. The prevalence of history of current or previous malignancy among patients admitted with TTS was 20% (113 subjects). When compared to non-cancer patients, patients with current or previous disease showed a statistically significant relative risk of clinical events (both in-hospital and at follow-up) (RR 1.82, 95%, 1.37–2.42, p<0.0001) (Figure 1). The risk of in-hospital events was higher in cancer group, although not significant (RR 1.30, 95% CI, 0.74–2.29, p=0.36), whereas events at follow-up were statistically more probable (RR 2.08, 95% CI, 1.50–2.87, p<0.00001). Nearly 17% of patients experienced subsequent tumors or relapses within 3.2±1.3 years. Additionally, gastrointestinal cancers were the most frequent associated neoplasms (23%), while nervous system and urinary cancer were the rarest (3% for each).

Conclusion: History of cancer carries an increased risk of adverse events in TTS patients; a careful follow-up may be reccomended in TTS with history of cancer.

Figure 1

The free consultation period for this content is over.

It is now only available year-round to ESC Professional Members, Fellows of the ESC, and Young combined Members

Get your access to resources

Join now
  • 1ESC Professional Members – access all ESC Congress resources 
  • 2ESC Association Members (Ivory, Silver, Gold) – access your Association’s resources
  • 3Under 40 or in training - with a Combined Membership, access all resources
Join now

Our sponsors

ESC 365 is supported by Bayer, Boehringer Ingelheim and Lilly Alliance, Bristol-Myers Squibb and Pfizer Alliance, Novartis Pharma AG and Vifor Pharma in the form of educational grants. The sponsors were not involved in the development of this platform and had no influence on its content.

logo esc

Our mission: To reduce the burden of cardiovascular disease

Who we are