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July 1, 2026Frontiers in Cardiovascular MedicineOpen Access

Male sex (OR 1.59) and older age (OR 1.32 per 5-year increase) were independently associated with higher in-hospital mortality in patients with takotsubo syndrome.

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Why the study?

The prognostic significance of age in takotsubo syndrome remains debated, and evidence regarding male patients is limited.

Do older age and male sex independently predict higher in-hospital mortality in patients with takotsubo syndrome?

Population

13,585 patients with a first takotsubo syndrome episode undergoing coronary angiography in Japan

Comparison

Comparisons across age groups (≤50, 51–74, ≥75 years) and sex

Design

Retrospective nationwide registry-based cohort study

Key result

Male sex (OR 1.59) and older age (OR 1.32 per 5-year increase) were independently associated with higher in-hospital mortality in patients with takotsubo syndrome.

Authors

THTomohiro HayashiKNKazuaki NegishiTKTakato Kobayashi

Discussion

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Overview

May inform risk stratification by sex and age in takotsubo syndrome; hypothesis-generating pending prospective validation.

Study Design

Type

Cohort (n=13,585)

Multicenter

Yes

Structured PICO

Do older age and male sex independently predict higher in-hospital mortality in patients with takotsubo syndrome?

P
Population
13,585 patients (81.2% female) hospitalized with a first episode of takotsubo syndrome who underwent coronary angiography, evaluated for in-hospital mortality.
O
Outcome
In-hospital mortalityhard clinical

Main Result

Odds Ratio: 1.59 (95% CI 1.3–1.95)

p-value: p=<0.001

In patients with takotsubo syndrome, older age and male sex are independent predictors of in-hospital mortality and are associated with a higher burden of comorbidities and need for intensive care.

Limitations

  • Retrospective observational study subject to inherent biases.
  • Administrative database lacking detailed clinical data such as vital signs, laboratory measurements, and echocardiographic findings.
  • Unable to assess triggering factors or differentiate between primary and secondary forms of TTS.
  • Could not distinguish cardiovascular from non-cardiovascular mortality.
  • Post-discharge information was unavailable, precluding evaluation of long-term outcomes.
  • Absence of detailed clinical variables in the database (e.g., left ventricular ejection fraction, biomarkers, trigger type, presence of left ventricular outflow tract obstruction, and TTS anatomical subtype)
  • Potential residual confounding
  • Inability to differentiate between primary and secondary TTS

Cite This Study

Hayashi et al. (2026) conducted a cohort in Takotsubo syndrome (n=13,585). Male sex and older age vs. Female sex and younger age was evaluated on In-hospital mortality (OR 1.59, 95% CI 1.30-1.95, p=<0.001). Male sex (OR 1.59) and older age (OR 1.32 per 5-year increase) were independently associated with higher in-hospital mortality in patients with takotsubo syndrome.

synapsesocial.com/papers/6a6caaa1f44fa9f079db5573https://doi.org/10.3389/fcvm.2026.1852892
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