Differences in Clinical Features and In-Hospital Outcomes of Older Adults with Tako-Tsubo Cardiomyopathy


Address correspondence to Rodolfo Citro, University Hospital “Scuola Medica Salernitana,” Heart Tower room 810. Largo Città di Ippocrate, Salerno 84100, Italy. E-mail: rodolfocitro@teletu.it



To describe the clinical characteristics and in-hospital outcomes of older adults with tako-tsubo cardiomyopathy (TTC).


Partially retrospective, partially prospective observational study.


Eleven Italian referral cardiac centers included in the Tako-tsubo Italian Network.


One hundred ninety consecutive individuals with TTC (92.1% female, mean age 66) were divided into three groups according to age (<65, n = 78; 65–74, n = 61; ≥75, n = 51).


Clinical findings and in-hospital outcomes were evaluated in each group.


Participants aged 65 and older had a greater prevalence of hypertension (P = .001) and a lower glomerular filtration rate (P < .001), and those aged 65 to 74 had a greater prevalence of psychiatric disorders (P = .01), ST-segment elevation on admission (P = .01) and a cerebrovascular disease (P = .003) than those younger than 65. Despite similar left ventricular ejection fraction (LVEF) on admission (P = .26), the oldest group had a lower LVEF at discharge (P = .03). Inotropic agents were used more frequently in older adults (P = .03). In-hospital composite adverse events (all-cause death, acute heart failure, life-threatening arrhythmias, stroke, and cardiogenic shock; P = .03) and overall complications (P = .004) were more common in participants aged 75 and older. Overall in-hospital mortality was low (2.8%) but was more prevalent in participants aged 75 and older (6.3%). On multivariate analysis, age of 75 and older (hazard ratio (HR) = 2.45, 95% confidence interval (CI) = 1.28–5.82, P = .04) and LVEF on admission (HR = 0.874, 95% CI = 0.81–0.95, P < .001) were the only independent predictors of in-hospital adverse events.


The clinical profile of participants aged 75 and older with TTC was different from that of those younger than 75 with TTC, and they had a higher in-hospital complication rate.