Elevated admission cardiac troponin-T was associated with higher unadjusted all-cause mortality (42% vs 16%) but was not an independent marker of in-hospital mortality (P=0.161) in COVID-19 patients.
Cohort (n=2,531)
No
Does male sex worsen clinical outcomes and mortality in patients with Takotsubo syndrome?
Male patients with Takotsubo syndrome represent a high-risk phenotype with significantly higher in-hospital and long-term mortality compared to female patients.
Absolute Event Rate: 42% vs 16%
p-value: p=<0.001
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.
“Male patients can have Takotsubo, and if they have it, they have a very high risk of long-term MACE. These patients should have aggressive follow-up in the first few months following the event and then every 6 months thereafter.”
Arcari et al. (Sun,) conducted a cohort in COVID-19 (n=2,531). Elevated cardiac troponin-T (> 0.014 ng/ml) vs. Normal cardiac troponin-T was evaluated on All-cause mortality (p=<0.001). Elevated admission cardiac troponin-T was associated with higher unadjusted all-cause mortality (42% vs 16%) but was not an independent marker of in-hospital mortality (P=0.161) in COVID-19 patients.