AJM onlineClinical research studyComorbidities Frequency in Takotsubo Syndrome: An International Collaborative Systematic Review Including 1109 Patients
Section snippets
Study Design
This systematic review was conducted following current guidelines, including the Cochrane Collaboration and Meta-analysis Of Observational Studies in Epidemiology,11 and the Preferred Reporting Items for Systematic reviews and Meta-Analyses amendment to the Quality of Reporting of Meta-analyses statement.12 The study was registered at the PROSPERO International prospective register of systematic reviews of the University of York, United Kingdom (registration no. CRD42013005175).13 All
Search Results
From a total of 295 initial citations that were found, we excluded those with duplicate reporting, as well as those that were reviews, were not written in English, or included small case series of patients or patients who were not diagnosed as having takotsubo syndrome on the basis of the Mayo Clinic criteria. Corresponding authors of the 87 studies that were selected according to explicit inclusion criteria were asked to participate in the COUNTS study. We then sent the study protocol and a
Discussion
The COUNTS Study has successfully merged 19 databases of previously published series of patients with takotsubo syndrome. Together, these databases comprise a total of >1100 patients with takotsubo syndrome, and therefore this is the largest collaborative review of such patients with detailed clinical data that has been conducted to date. The major finding of the study is that patients with takotsubo syndrome have a relevant prevalence of cardiovascular risk factors, with frequency similar to
Conclusions
The COUNTS study provides a unique substrate to support a reliable definition of clinical characteristics of patients with takotsubo syndrome. Indeed, the demonstration, in the largest series of patients with takotsubo syndrome reported to date, that cardiovascular risk factors and some comorbidities known to be associated with excessive catecholamine production have a high prevalence in patients with takotsubo syndrome supports the concept that “predisposing factors” may play a crucial
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Funding: None.
Conflict of Interest: None.
Authorship: All authors had access to the data and played a role in writing the manuscript.