Gender Differences in Takotsubo Syndrome.

Female Humans Male Registries Sex Characteristics Sex Factors Shock, Cardiogenic / complications Takotsubo Cardiomyopathy / complications
cardiogenic shock follow-up gender male sex prognosis takotsubo

Journal

Journal of the American College of Cardiology
ISSN: 1558-3597
Titre abrégé: J Am Coll Cardiol
Pays: United States
ID NLM: 8301365

Informations de publication

Date de publication:
31 05 2022
Historique:
received: 31 01 2022
revised: 14 03 2022
accepted: 21 03 2022
entrez: 26 5 2022
pubmed: 27 5 2022
medline: 31 5 2022
Statut: ppublish

Résumé

Male sex in takotsubo syndrome (TTS) has a low incidence and it is still not well characterized. The aim of the present study is to describe TTS sex differences. TTS patients enrolled in the international multicenter GEIST (GErman Italian Spanish Takotsubo) registry were analyzed. Comparisons between sexes were performed within the overall cohort and using an adjusted analysis with 1:1 propensity score matching for age, comorbidities, and kind of trigger. In total, 286 (11%) of 2,492 TTS patients were men. Male patients were younger (age 69 ± 13 years vs 71 ± 11 years; P = 0.005), with higher prevalence of comorbid conditions (diabetes mellitus 25% vs 19%; P = 0.01; pulmonary diseases 21% vs 15%; P = 0.006; malignancies 25% vs 13%; P < 0.001) and physical trigger (55 vs 32% P < 0.01). Propensity-score matching yielded 207 patients from each group. After 1:1 propensity matching, male patients had higher rates of cardiogenic shock and in-hospital mortality (16% vs 6% and 8% vs 3%, respectively; both P < 0.05). Long-term mortality rate was 4.3% per patient-year (men 10%, women 3.8%). Survival analysis showed higher mortality rate in men during the acute phase in both cohorts (overall: P < 0.001; matched: P = 0.001); mortality rate after 60 days was higher in men in the overall (P = 0.002) but not in the matched cohort (P = 0.541). Within the overall population, male sex remained independently associated with both in-hospital (OR: 2.26; 95% CI: 1.16-4.40) and long-term mortality (HR: 1.83; 95% CI: 1.32-2.52). Male TTS is featured by a distinct high-risk phenotype requiring close in-hospital monitoring and long-term follow-up.

Sections du résumé

BACKGROUND
Male sex in takotsubo syndrome (TTS) has a low incidence and it is still not well characterized.
OBJECTIVES
The aim of the present study is to describe TTS sex differences.
METHODS
TTS patients enrolled in the international multicenter GEIST (GErman Italian Spanish Takotsubo) registry were analyzed. Comparisons between sexes were performed within the overall cohort and using an adjusted analysis with 1:1 propensity score matching for age, comorbidities, and kind of trigger.
RESULTS
In total, 286 (11%) of 2,492 TTS patients were men. Male patients were younger (age 69 ± 13 years vs 71 ± 11 years; P = 0.005), with higher prevalence of comorbid conditions (diabetes mellitus 25% vs 19%; P = 0.01; pulmonary diseases 21% vs 15%; P = 0.006; malignancies 25% vs 13%; P < 0.001) and physical trigger (55 vs 32% P < 0.01). Propensity-score matching yielded 207 patients from each group. After 1:1 propensity matching, male patients had higher rates of cardiogenic shock and in-hospital mortality (16% vs 6% and 8% vs 3%, respectively; both P < 0.05). Long-term mortality rate was 4.3% per patient-year (men 10%, women 3.8%). Survival analysis showed higher mortality rate in men during the acute phase in both cohorts (overall: P < 0.001; matched: P = 0.001); mortality rate after 60 days was higher in men in the overall (P = 0.002) but not in the matched cohort (P = 0.541). Within the overall population, male sex remained independently associated with both in-hospital (OR: 2.26; 95% CI: 1.16-4.40) and long-term mortality (HR: 1.83; 95% CI: 1.32-2.52).
CONCLUSIONS
Male TTS is featured by a distinct high-risk phenotype requiring close in-hospital monitoring and long-term follow-up.

Identifiants

DOI: 10.1016/j.jacc.2022.03.366 PMID: 35618345 PMC: PMC8972425
pubmed: 35618345
pii: S0735-1097(22)04631-9
doi: 10.1016/j.jacc.2022.03.366
pmc: PMC8972425
pii:
doi:

Types de publication

Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

2085-2093

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © 2022 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Funding Support and Author Disclosures The authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Auteurs

Luca Arcari (L)

Institute of Cardiology, Madre Giuseppina Vannini Hospital, Rome, Italy.

Iván J Núñez Gil (IJ)

Interventional Cardiology, Cardiovascular Institute, Hospital Clínico Universitario San Carlos, Madrid, Spain.

Thomas Stiermaier (T)

University Heart Center Lübeck, Medical Clinic II (Cardiology/Angiology/Intensive Care Medicine) and German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck, Lübeck, Germany.

Ibrahim El-Battrawy (I)

Department of Cardiology, University of Mannheim, Mannheim, Germany; Department of Cardiology and Angiology, Bergmannsheil University Hospitals, Ruhr University of Bochum, Bochum, Germany.

Federico Guerra (F)

Cardiology and Arrhythmology Clinic, Marche Polytechnic University, University Hospital "Umberto I - Lancisi - Salesi", Ancona, Italy.

Giuseppina Novo (G)

Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Cardiology Unit, University of Palermo, University Hospital P. Giaccone, Palermo, Italy.

Beatrice Musumeci (B)

Cardiology, Clinical and Molecular Medicine Department, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy.

Luca Cacciotti (L)

Institute of Cardiology, Madre Giuseppina Vannini Hospital, Rome, Italy.

Enrica Mariano (E)

Division of Cardiology, University of Rome Tor Vergata, Rome, Italy.

Pasquale Caldarola (P)

Department of Cardiology, San Paolo Hospital, Bari, Italy.

Giuseppe Parisi (G)

Department of Cardiology, San Paolo Hospital, Bari, Italy.

Roberta Montisci (R)

Clinical Cardiology, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy.

Enrica Vitale (E)

University of Foggia, Department of Medical and Surgical Sciences, Foggia, Italy.

Matteo Sclafani (M)

Cardiology, Clinical and Molecular Medicine Department, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy.

Massimo Volpe (M)

Cardiology, Clinical and Molecular Medicine Department, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy.

Miguel Corbì-Pasqual (M)

Department of Cardiology, Complejo Hospitalario de Albacete, Albacete, Spain.

Manuel Martinez-Selles (M)

Department of Cardiology, Hospital General Universitario Gregorio Marañon, CIBERCV, and Universidad Europea, Universidad Complutense, Madrid, Spain.

Manuel Almendro-Delia (M)

Servicio de Cardiología, Hospital Virgen de la Macarena, Sevilla, Spain.

Alessandro Sionis (A)

Unidad de Cuidados Intensivos Cardiológicos, Servicio de Cardiología, Hospital de Sant Pau, Instituto de Investigación Biomédica Sant Pau (IIB Sant Pau), Barcelona, Spain.

Aitor Uribarri (A)

Department of Cardiology, Hospital vall d'hebron, Barcelona, Spain.

Ibrahim Akin (I)

Department of Cardiology, University of Mannheim, Mannheim, Germany.

Holger Thiele (H)

Heart Center Leipzig at University of Leipzig and Leipzig Heart Institute, Department of Internal Medicine/Cardiology, Leipzig, Germany.

Natale Daniele Brunetti (ND)

University of Foggia, Department of Medical and Surgical Sciences, Foggia, Italy. Electronic address: natale.brunetti@unifg.it.

Ingo Eitel (I)

University Heart Center Lübeck, Medical Clinic II (Cardiology/Angiology/Intensive Care Medicine) and German Center for Cardiovascular Research (DZHK), partner site Hamburg/Kiel/Lübeck, Lübeck, Germany.

Francesco Santoro (F)

University of Foggia, Department of Medical and Surgical Sciences, Foggia, Italy.

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Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Gender Differences in Takotsubo Syndrome.
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Collecte de données › Enregistrements › Gender Differences in Takotsubo Syndrome.
questionsmedicales.fr › Phénomènes physiologiques des appareils urinaire et reproducteur › Phénomènes physiologiques de la reproduction › Caractères sexuels › Gender Differences in Takotsubo Syndrome.
questionsmedicales.fr › Environnement et santé publique › Santé publique › Facteurs épidémiologiques › Facteurs sexuels › Gender Differences in Takotsubo Syndrome.
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Choc › Choc cardiogénique › Gender Differences in Takotsubo Syndrome.
questionsmedicales.fr › Maladies cardiovasculaires › Cardiopathies › Dysfonction ventriculaire › Dysfonction ventriculaire gauche › Syndrome de tako-tsubo › Gender Differences in Takotsubo Syndrome.