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Prevalence of thrombophilic disorders in takotsubo patients: the (ThROmbophylia in TAkotsubo cardiomyopathy) TROTA study

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Abstract

Takotsubo cardiomyopathy (TTC) pathophysiology is still unclear. A transient intracoronary thrombosis dissolved at the time of angiography has been hypothesized. We aimed to evaluate the prevalence of thrombophilic disorders in TTC patients. In 75 TTC women, 75 age- and sex-matched acute coronary syndrome (ACS) patients, both enrolled during the acute phase, and in 75 control subjects, we compared the prevalence of congenital and acquired thrombophilic alterations and the values of clotting and endothelial activation biomarkers. Some parameters were re-assessed 1 month after the acute phase in TTC patients. No significant difference between the three groups was observed in factor II (G20210A) and V (G1691A) polymorphisms prevalence. Homocysteine levels were significantly higher in ACS patients vs. TTC and control subjects. Lipoprotein(a) values trended to be higher in TTC patients vs. control subjects, though not significantly. Other thrombophilic alterations in TTC patients were similar to that previously reported in healthy women. Von Willebrand factor and plasminogen activator inhibitor-1 were significantly higher in TTC and in ACS patients than controls. Clotting activation biomarkers were not statistically different between TTC patients and controls. During follow-up, in TTC patients, endothelial damage indices significantly decreased while clotting activation biomarkers remained unchanged. In conclusion, our results, showing a rate of thrombophilic alterations in TTC patients similar to control subjects, do not support the transient intracoronary thrombus hypothesis. However, several endothelial damage markers and lipoprotein(a) were higher in TTC patients vs. controls suggesting a role of endothelial dysfunction and of other factors concurring to hyperviscosity, as recently hypothesized.

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Acknowledgments

Special thanks to Rosanna Abbate, Professor of Internal Medicine and Atherothrombotic Disease.

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Authors and Affiliations

  1. Cardiovascular and Thoracic Department, Azienda Ospedaliero-Universitaria Careggi, Viale Morgagni, 85, Florence, Italy

    Emanuele Cecchi, Guido Parodi, Serena Fatucchi, Paola Angelotti, Cristina Giglioli, Benedetta Bellandi, Lucia Mannini & David Antoniucci

  2. Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy

    Anna Maria Gori, Brunella Bandinelli, Elena Sticchi, Ilaria Romagnuolo & Rosanna Abbate

  3. Centro S. Maria agli Ulivi, Fondazione Don Carlo Gnocchi Onlus IRCCS, Florence, Italy

    Anna Maria Gori

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  1. Emanuele Cecchi
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Correspondence to Emanuele Cecchi.

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Cecchi, E., Parodi, G., Fatucchi, S. et al. Prevalence of thrombophilic disorders in takotsubo patients: the (ThROmbophylia in TAkotsubo cardiomyopathy) TROTA study. Clin Res Cardiol 105, 717–726 (2016). https://doi.org/10.1007/s00392-016-0977-x

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