Takotsubo Cardiomyopathy (TCM) is characterized by transient left ventricular dysfunction in patients with normal findings on coronary angiography. A simultaneous incidence of coronary artery disease and TCM was described in literature, but the clinical characteristics and the prognosis of this population have not been yet assessed. The aim of our study is to analyze the prognostic impact of simultaneous coronary artery disease in patients with TCM.

A retrospective monocentric study enrolling 58 patients hospitalized for TCM between January 2002 and January 2013. Demographic characteristics, clinical features, angiographic results and outcomes were analyzed.

The mean age of our population was 58±12 years. Hypertension and dyslipidemia were the most common risk factors for coronary heart disease (63.8% and 34.5% respectively). Angiographic assessment demonstrated atherosclerotic lesions in Left Anterior Descending (LAD) artery in 17þpatients (29.3%), among which 12 patients (20.7%) had only non significant lesions. Two patients have significant lesions (stenosis >50%) in LAD and three in diagonal artery branch. In-hospital complications occured in 7 patients (12%) and included acute pulmonary oedema (n=5), cardiogenic shock (n=2) and death (n=2). In univariate analysis, lesions in LAD was a predictive factor of in-hospital outcomes (p=0.02). However, significant lesions in LAD were not associated with in-hospital major events (p=0.6). After a mean follow-up of 56±31 months, long-term major events (death, recurrence and cardiac hospitalization) occured in 30.4% of patients. Coronary artery disease was not associated with long-term cardiac events (p=0.58).

Our study demonstrated that coronary lesions in LAD are associated with in-hospital major cardiac events.