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Cancer may be associated with broken heart syndrome
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Patients with cancer had an increased risk for takotsubo syndrome, also known as broken heart syndrome, according to a study published in the Journal of the American Heart Association.
“Patients with broken heart syndrome might benefit if screened for cancer to improve their overall survival,” Christian Templin, MD, PhD, director of interventional cardiology at the Andreas Grüntzig Heart Catheterization Laboratories at University Hospital Zurich, said in a press release. “Our study also should raise awareness among oncologists and hematologists that broken heart syndrome should be considered in patients undergoing cancer diagnosis or treatment who experience chest pain, shortness of breath or abnormalities on their electrocardiogram.”
Victoria L. Cammann , MD, of the University Heart Center at University Hospital Zurich, and colleagues analyzed data from 1,604 patients with takotsubo syndrome from the InterTAK registry who had available data on their malignancy status. Patients were then categorized by the presence (n = 267; mean age, 70 years; 88% women) or absence of a malignancy (n = 1,337; mean age, 66 years; 90% women).
A subanalysis was also performed to compare patients with takotsubo syndrome (n = 411) with those who had ACS (n = 441).
Patients with malignancy were more likely to have physical triggers compared with those without malignancy (47.9% vs. 34.2%; P < .001). These patients were also less likely to have emotional stressors (18% vs. 30.3%; P < .001).
Compared with the nonmalignancy group, the malignancy group had comparable rates of 30-day mortality (P = .17) and higher rates of long-term mortality (P < .001).
The subanalysis found that patients with takotsubo syndrome and ACS had similar rates of long-term mortality (P = .13).
An independent predictor of long-term mortality was malignancy.
“Our findings suggest that specific malignancy-associated factors impact the development and outcome of [takotsubo syndrome],” Cammann and colleagues wrote. “Therefore, to fully understand the pathophysiology of [takotsubo syndrome] and the role of malignancy in triggering or affecting outcomes, this subset of patients deserves further investigation.” – by Darlene Dobkowski
Disclosures: The authors report no relevant financial disclosures.
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C. Noel Bairey Merz, MD, FACC, FAHA, FESC
This study has a new finding of an association of uncertain linkage between malignancy and takotsubo syndrome.
These findings need to be replicated and investigated as to true vs. confounded linkage. For example, subjects with takotsubo syndrome come to medical attention and undergo evaluation, potentially leading to an earlier but incidental diagnosis of malignancy.
Routine medical evaluation at the time of takotsubo syndrome is typically done and appears prudent.
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