Incidence, characteristics, determinants, and prognostic impact of recurrent syncope

Zimmermann, Tobias and du Fay de Lavallaz, Jeanne and Nestelberger, Thomas and Gualandro, Danielle M. and Strebel, Ivo and Badertscher, Patrick and Lopez-Ayala, Pedro and Widmer, Velina and Freese, Michael and Miró, Òscar and Christ, Michael and Cullen, Louise and Than, Martin and Martin-Sanchez, F. Javier and Di Somma, Salvatore and Peacock, W. Frank and Keller, Dagmar I. and Boeddinghaus, Jasper and Twerenbold, Raphael and Wussler, Desiree and Koechlin, Luca and Walter, Joan E. and Bürgler, Franz and Geigy, Nicolas and Kühne, Michael and Reichlin, Tobias and Lohrmann, Jens and Mueller, Christian. (2020) Incidence, characteristics, determinants, and prognostic impact of recurrent syncope. EP Europace, 22 (12). pp. 1885-1895.

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The aim of this study is to characterize recurrent syncope, including sex-specific aspects, and its impact on death and major adverse cardiovascular events (MACE).; We characterized recurrent syncope in a large international multicentre study, enrolling patients ≥40 years presenting to the emergency department (ED) with a syncopal event within the last 12 h. Syncope aetiology was centrally adjudicated by two independent cardiologists using all information becoming available during syncope work-up and long-term follow-up. Overall, 1790 patients were eligible for this analysis. Incidence of recurrent syncope was 20% [95% confidence interval (CI) 18-22%] within the first 24 months. Patients with an adjudicated final diagnosis of cardiac syncope (hazard ratio (HR) 1.50, 95% CI 1.11-2.01) or syncope with an unknown aetiology even after central adjudication (HR 2.11, 95% CI 1.54-2.89) had an increased risk for syncope recurrence. Least Absolute Shrinkage and Selection Operator regression fit on all patient information available early in the ED identified >3 previous episodes of syncope as the only independent predictor for recurrent syncope (HR 2.13, 95% CI 1.64-2.75). Recurrent syncope carried an increased risk for death (HR 1.87, 95% CI 1.26-2.77) and MACE (HR 2.69, 95% CI 2.02-3.59) over 24 months of follow-up, however, with a time-dependent effect. These findings were confirmed in a sensitivity analysis excluding patients with syncope recurrence or MACE before or during ED evaluation.; Recurrence rates of syncope are substantial and vary depending on syncope aetiology. Importantly, recurrent syncope carries a time-dependent increased risk for death and MACE.; BAsel Syncope EvaLuation (BASEL IX, ClinicalTrials.gov registry number NCT01548352).
Faculties and Departments:03 Faculty of Medicine > Bereich Medizinische Fächer (Klinik) > Kardiologie > Klinische Outcomeforschung Kardiologie (Müller)
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Medizinische Fächer (Klinik) > Kardiologie > Klinische Outcomeforschung Kardiologie (Müller)
UniBasel Contributors:Zimmermann, Tobias and Nestelberger, Thomas and du Fay de Lavallaz, Jeanne and Müller, Christian
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:Oxford University Press
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:07 Apr 2022 11:42
Deposited On:07 Apr 2022 11:42

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