AUTHOR=Núñez-Gil Iván J. , Santoro Francesco , Vazirani Ravi , Novo Giuseppina , Blanco-Ponce Emilia , Arcari Luca , Uribarri Aitor , Cacciotti Luca , Guerra Federico , Salamanca Jorge , Musumeci Beatrice , Vedia Oscar , Mariano Enrica , Fernández-Cordón Clara , Caldarola Pasquale , Montisci Roberta , Brunetti Natale Daniele , El-Battrawy Ibrahim , Abumayyaleh Mohammad , Akin Ibrahim , Eitel Ingo , Stiermaier Thomas 

TITLE=Smoking influence in Takotsubo syndrome: insights from an international cohort

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 10 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2023.1282018

DOI=10.3389/fcvm.2023.1282018

ISSN=2297-055X

ABSTRACT=Aims: To assess the influence of tobacco on acute and long-term outcomes in Takotsubo Syndrome (TTS).Methods: TTS patients from the international multicenter GErman Italian Spanish Takotsubo registry (GEIST) were analyzed. Comparisons between groups were performed within the overall cohort, and an adjusted analysis with 1:1 propensity score matching was conducted.Results: Out of 3152 TTS patients, 534 (17%) were current smokers. Smoker TTS patients were younger (63±11 vs. 72±11 years, p<0.001), less frequently female (78% vs. 90%, p<0.001), and had a lower prevalence of hypertension (59% vs. 69%, p<0.01) and diabetes mellitus (16% vs. 20%, p=0.04), but a higher prevalence of pulmonary (21% vs. 15%, p<0.01) and/or psychiatric diseases (17% vs. 12%, p<0.01).On multivariable analysis, age less than 65 years [OR 3.85, 95%CI (2.86-5)], male gender [OR 2.52, 95%CI (1.75-3.64)], history of pulmonary disease [OR 2.56, 95%CI (1.81-3.61)], coronary artery disease [OR 2.35, 95%CI (1.60-3.46)] and non-apical ballooning form [OR 1.47, 95%CI (1.02-2.13)]   were associated with smoking status.PSM 1:1 yielded 329 patients from each group. Smokers had similar rate of in-hospital complications but longer in hospital stay (10 vs 9 days, p=0.01). During long-term follow-up, there was no differences in mortality rates between smokers and non-smokers (5.6% vs 6.9% yearly in the overall, p=0.02, and 6.6%, vs 7.2% yearly in the matched cohort, p=0.97).Our findings suggest that smoking may influence the clinical presentation and course of TTS with longer in hospital stay, but does not independently impact mortality.