Predicting the risk of takotsubo syndrome development


DOI: https://dx.doi.org/10.18565/therapy.2024.10.43-51

Evdokimov D.S., Feoktistova V.S., Semenova A.P., Boldueva S.A., Plavinsky S.L.

I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia, Saint Petersburg
Abstract. According to the literature data, patients with takotsubo syndrome (TS) often develop complications up to including death both in the acute and remote periods of the disease. In this regard, it seems important to identify predictors of the risk of TS developing.
The aim: to construct models for predicting the risk of TS developing based on clinical and laboratory-instrumental data.
Material and methods. The main group included 60 patients with TS (mean age 65.5 ± 13.4 years), including 55 (91.7%) females, control group (CG) – 40 persons (66.6 ± 10.4 years), including 39 (97.5%) females. In the first 14 days of the disease, patients with TS and CG individuals underwent standard clinical and laboratory examination, cardiorhythmography with vegetative tests and psychological testing using validated questionnaires.
Results. According to the data of univariate analysis, the greatest influence on the risk of TS developing was exerted by the points scored on the questionnaires of A.M. Vein, Spielberger – Khanin (reactive anxiety), Beck Depression Scales (somatization), HADS (anxiety), Kirshnev stress resistance test, PSS-10 (perceived stress scale). In the process of constructing an integral model for predicting TS development using CHAID method with the use of data from all scales, the first prognostically significant scale was reactive anxiety subscale of Spielberger – Khanin questionnaire with a threshold value of 34 points, exceeding which increases the probability of developing the disease to 66.7%. At the same time, if the respondent’s index of the “control” component of resilience is 18 points or less, then the risk of developing TS will increase to 100%. Sensitivity of the resulting model was 100%, specificity – 52.5%. The overall percentage of correctly predicted observations reached 75.6%.
Conclusion. Psychological factors (anxiety-depressive disorders, decreased stress resistance and resilience) allowed us to predict the risk of TS developing.
Keywords: risk assessment model, risk factors for takotsubo syndrome, Takotsubo syndrome
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About the Autors

Dmitry S. Evdokimov, MD, assistant at the Department of faculty therapy, I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia. Address: 195067, Saint Petersburg, 47 Piskarevsky Highway.
E-mail: kasabian244@gmail.com
ORCID: https://orcid.org/0000-0002-3107-1691
Valeria S. Feoktistova, MD, PhD (Medicine), associate professor of the Department of faculty therapy, I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia. Address: 195067, Saint Petersburg, 47 Piskarevsky Highway.
E-mail: lerissima@yandex.ru
ORCID: https://orcid.org/0000-0003-4161-3535
Alena P. Semenova, MD, postgraduate student of the Department of faculty therapy, I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia. Address: 195067, Saint Petersburg, 47 Piskarevsky Highway.
E-mail: semionova.al@mail.ru
ORCID: https://orcid.org/0000-0002-6386-1612
Svetlana A. Boldueva, MD, PhD (Medicine), professor, head of the Department of faculty therapy, I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia. Address: 195067, Saint Petersburg, 47 Piskarevsky Highway.
E-mail: svetlanaboldueva@mail.ru
ORCID: https://orcid.org/0000-0002-1898-084X
Svyatoslav L. Plavinsky , MD, Dr. Sci. (Medicine), professor of the Department of pedagogy, philosophy and law, I.I. Mechnikov North-Western State Medical University of the Ministry of Healthcare of Russia. Address: 195067, Saint Petersburg, 47 Piskarevsky Highway.
ORCID: https://orcid.org/0000-0001-9159-6177


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