Gender-based comparison of takotsubo syndrome versus myocardial infarction

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Abstract

Background: Takotsubo Syndrome (TTS) is an acute reversible left ventricular dysfunction. Recently published studies have highlighted a similar mortality rate as acute coronary syndrome (ACS). We compared the impact of gender differences on the outcome of TTS patients as compared to ACS patient. Design and methods: We included a collective of 138 patients TTS between 2003 and 2016 at our institution. Patients were divided according to their gender into two groups (Males n¼21, 15% and females, n¼117, 85%). They were compared with a cohort of 300 patients with a diagnosis of ACS. Results: On the acute phase, in male patients with TTS, a treatment with inotropic was more often required (33.3 vs. 11.5%, P<0.01), were more susceptible to cardiogenic shock (28.6 vs. 12.5%, P<0.04). Concerning the long-term prognosis after the acute event, male patients had higher all-cause mortality over long-term follow-up. A Kaplan–Meier analysis indicated that the mortality of male patients with TTS was significantly higher compared to male patients with ACS (log-rank <0.01), while there was no significant difference between female patients with TTS and ACS (log-rank ¼0.60, P¼0.45). In a multivariate cox regression analysis, male gender (HR 2.7, 95% CI: 1.1–6.5, P¼0.02) GFR <60 ml/min (HR 2.8, 95% CI: 1.2–6.0, P¼0.01) and history of cancer (HR 3.6, 95% CI 1.4–9.3, P<0.01) were independent predictors of 5-year mortality. Conclusions: Considerable evidence suggests that TTS compared to ACS implicates more significant clinical short-term events on male patients and it may be associated with poorer long-term prognosis.

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APA

Giannakopoulos, K., El-Battrawy, I., Gietzen, T., Ansari, U., Borggrefe, M., & Akin, I. (2019). Gender-based comparison of takotsubo syndrome versus myocardial infarction. QJM: An International Journal of Medicine , 112(5), 355–362. https://doi.org/10.1093/qjmed/hcz033

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