To elucidate age- and sex-specific differences in clinical characteristics and outcomes of patients with Takotsubo syndrome (TTS) using a large nationwide Japanese registry.
Approach:
Study Design: Retrospective cohort study using the Japanese Registry of All Cardiac and Vascular Diseases–Diagnosis Procedure Combination database from 2012 to 2022.
Patient Selection: Included patients with the first TTS episode who underwent coronary angiography and met Mayo Clinic diagnostic criteria.
Statistical Analysis: Multivariable logistic regression was used to assess independent in-hospital mortality predictors.
Key Findings:
Among 13,585 patients, 2,558 (18.8%) were men, and 523 (3.8%), 5,354 (39.4%), and 7,708 (56.7%) were aged ≤50, 51–74, and ≥75 years, respectively.
Men had more comorbidities and required more intensive care than women.
In-hospital mortality was higher in men across all age groups compared to women: ≤50 years: 3.0% (men) vs. 1.5% (women); 51–74 years: 4.3% (men) vs. 1.5% (women); ≥75 years: 8.2% (men) vs. 4.6% (women).
Older age (OR 1.32 per 5 years) and male sex (OR 1.59) were independent predictors of in-hospital mortality.
Interpretation:
Limitations:
The study is retrospective and may be subject to biases inherent in such designs.
Further prospective validation of findings is warranted.
Conclusion:
Older age and male sex were identified as independent predictors of in-hospital mortality in TTS patients.
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