Sex Differences in Stress-Induced (Takotsubo) Cardiomyopathy.

Area of Science:

• Cardiology
• Sex-based medicine
• Clinical outcomes research

Background:

• Takotsubo cardiomyopathy (TC) predominantly affects women.
• Limited data exist on long-term outcomes for men with TC.
• Prior studies suggest potentially worse short-term outcomes for men.

Purpose of the Study:

• To investigate sex-based differences in short- and long-term outcomes for patients with Takotsubo cardiomyopathy (TC).
• To test the hypothesis that men with TC experience worse outcomes than women.

Main Methods:

• Retrospective analysis of patients diagnosed with TC between 2005-2018 within the Veteran Affairs system.
• Evaluation of in-hospital mortality, 30-day stroke/death risk, and long-term mortality.
• Multivariable regression analysis to identify independent predictors of outcomes.

Main Results:

• Men (69%) had higher in-hospital mortality (8.1% vs 1%) and were older.
• Female sex was an independent predictor of improved in-hospital mortality (OR 0.25) and lower long-term mortality (HR 0.71).
• No significant difference in 30-day stroke/death; women had higher TC recurrence (3.6% vs 1.1%).

Conclusions:

• In a predominantly male TC cohort, men experienced less favorable short- and long-term outcomes compared to women.
• Female sex is associated with better in-hospital and long-term survival after Takotsubo cardiomyopathy.
• Women showed a higher likelihood of TC recurrence.