For a study, researchers sought to describe TTS sex differences. TTS patients who participated in the worldwide multicenter GEIST (GErman Italian Spanish Takotsubo) registry were studied. Within the entire cohort, sexes were compared using an adjusted analysis with a 1:1 propensity score matching age, comorbidities, and trigger type. Men made up 286 (11%) of the 2,492 TTS cases. Male patients were younger (69+13 years vs 71+11 years; P=0.005), with a greater frequency of concomitant disorders (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). Each group received 207 patients as a result of propensity-score matching. Male patients showed higher rates of cardiogenic shock and in-hospital death after 1:1 propensity matching (16% vs 6% and 8% vs 3%, respectively; both P<0.05). The long-term death rate per patient-year was 4.3% (men 10%, women 3.8%). Survival analysis revealed that males died at a greater rate in both cohorts during the acute phase (overall: P=0.001; matched: P=0.001); the death rate after 60 days was higher in men in overall (P=0.002) but not in the matched cohort (P=0.541). Male sex remained independently linked with both in-hospital (OR: 2.26; 95% CI: 1.16-4.40) and long-term mortality in the whole population (HR: 1.83; 95% CI: 1.32-2.52). Male TTS had a particular high-risk phenotype that needed intensive in-hospital monitoring and long-term follow-up.
Reference:www.jacc.org/doi/10.1016/j.jacc.2022.03.366
