Characteristics and outcomes of spontaneous coronary artery dissection versus Takotsubo Syndrome: a systematic review and meta-analysis

INTRODUCTION: This systematic review compared the characteristics and clinical outcomes between patients with spontaneous coronary artery dissection (SCAD) and those with Takotsubo Syndrome (TS).EVIDENCE ACQUISITION: A systematic literature search was performed in PubMed, Embase, Cochrane Library, Scopus, Web of Science, and ClinicalTrials.gov from inspection to February 1st, 2025, then it was updated on February 7th, 2026. The search strategy used the following key words: “Spontaneous Coronary Artery Dissection” OR “Coronary Artery Dissection” OR “SCAD”. Additional search was done by adding “Takotsubo Cardiomyopathy,” “Takotsubo Cardiomyopathies,” or “Takotsubo Syndrome.” Data from six studies were analyzed.EVIDENCE SYNTHESIS: Patients with SCAD were significantly younger and exhibited lower rates of comorbidities such as dyslipidemia, hypertension, and diabetes than those with TS. Physical stress as a trigger occurred less frequently in patients with SCAD (odds ratio (OR) 0.37, 95% confidence interval (CI): 0.17; 0.83, P=0.0152; I2=91%), who tend to have higher left ventricular ejection fraction value (MD=14.12, 95% CI: 6.71; 21.62, P=0.0002; I2=100%). While there was no significant difference between the groups in terms of in-hospital death or stroke at follow-up, patients with SCAD had significantly lower risk of death at follow-up (OR=0.07, 95% CI: 0.03; 0.21, P<0.0001; I2=0%) than patients with TS.CONCLUSIONS: In conclusion, patients with SCAD were younger with less frequent comorbidities, and exhibited better long-term survival outcome than those with TS.