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Comparative Study
. 2024 Dec 3;13(23):e036800.
doi: 10.1161/JAHA.124.036800. Epub 2024 Nov 29.

Cardiogenic Shock Complicating Takotsubo Syndrome: Sex-Related Differences

Marco Tomasino  1 , Iván J Núñez-Gil  2   3 , Manuel Martínez-Selles  4 , Oscar Vedia  2   3 , Miguel Corbí-Pascual  5 , Jorge Salamanca  6 , Emilia Blanco-Ponce  7 , Clara Fernández Cordón  8 , Manuel Almendro-Delia  9 , Alberto Pérez-Castellanos  10 , Agustín Martín-García  11 , Sofía Vila-Sanjuán  1   1 , Ravi Vazirani  2   3 , Albert Duran-Cambra  12 , Victor M Becerra-Muñoz  13 , Marta Guillén-Marzo  14 , Aitor Uribarri  1   1   15   16
Affiliations
Comparative Study

Cardiogenic Shock Complicating Takotsubo Syndrome: Sex-Related Differences

Marco Tomasino et al. J Am Heart Assoc. .

Abstract

Background: Sex-related differences in Takotsubo syndrome have been described, but no information is available in patients who develop cardiogenic shock.

Methods and results: Of 412 patients with Takotsubo syndrome with cardiogenic shock, 71 (17.2%) were men. Male patients were older (71.1±12.2 versus 65.3±17.1 years, P<0.001), more frequently smokers (47 [66.2%] versus 66 [19.4%], P<0.01), with higher prevalence of neoplasms (6 [8.5%] versus 8 [2.3%], P=0.01), lower left ventricular ejection fraction (31% versus 37%, P<0.001), more frequent invasive mechanical ventilation (30 [42.3%] versus 90 [26.4%], P=<0.01), higher rate of infections (43 [60.6%] versus 148 [43.4%], P=<0.01), and longer in-hospital stay (19±20 days versus 13±15 days, P=0.02). A total of 55 patients (13.3%) died during hospital admission, and 90 patients (21.8%) died at the end of the 5-year follow-up. Male sex was not significantly associated with the in-hospital (odds ratio, 1.31 [95% CI, 0.64-2.68]) or 5-year mortality rate (hazard ratio, 1.66 [95% CI, 0.93-2.94]). In the matched cohort, no significant differences in the short- and long-term mortality rate were found either.

Conclusions: Cardiogenic shock due to Takotsubo syndrome has high short- and long-term mortality rates that are similar in men and women.

Keywords: Takotsubo; cardiogenic shock; heart failure; prognosis; sex.

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Conflict of interest statement

None.

Figures

Figure 1
Figure 1. Algorithm of the study design.
The study consisted of an analysis of the Spanish multicenter RETAKO registry. The diagram depicts the study design, for which comparisons were carried out between male and female patients with TTS both in the overall and matched cohorts. CS indicates cardiogenic shock; CS‐TTS, cardiogenic shock complicating Takotsubo syndrome; RETAKO, Registry of Takotsubo syndrome; and SCAI, Society for Cardiovascular Angiography and Interventions.
Figure 2
Figure 2. Short‐ and long‐term outcomes‐based sex.
A, Overall cohort (n=412 consecutive CS‐TTS patients). B, Matched cohort (n=110 paired CS‐TTS patients). CS‐TTS indicates cardiogenic shock complicating Takotsubo syndrome.
See this image and copyright information in PMC

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