Key result
The 10-point Takotsubo syndrome scoring system yielded significantly higher scores in TS patients compared to anterior STEMI and all-comer STEMI (8.3 vs. 5.7 vs. 3.83, P<0.001), with an AUC of 0.83.
Why the study?
Takotsubo syndrome mimics acute coronary syndrome, and the authors sought to validate a previously developed scoring system on a larger cohort.
Does a 10-point scoring system accurately distinguish Takotsubo syndrome from acute coronary syndrome in patients admitted to an intensive cardiovascular care unit?
Cohort (n=1,150)
Does a 10-point scoring system accurately distinguish Takotsubo syndrome from acute coronary syndrome in patients admitted to an intensive cardiovascular care unit?
Effect estimate: AUC 0.83
Absolute Event Rate: 8.3% vs 5.7%
p-value: p=<0.001
A 10-point clinical scoring system can reliably distinguish Takotsubo syndrome from acute coronary syndrome with good diagnostic accuracy (AUC 0.83).
May aid TS differentiation in the ICCU; leaves open need for prospective validation before practice change.
Background: Takotsubo syndrome (TS) mimics acute coronary syndrome in 1% to 3% of patients presenting with chest pain, ECG changes and echocardiographic transient apical wall hypokinesia. Objectives: This study aimed to validate a previously developed scoring system on a larger cohort size. Methods: Patients admitted to an intensive cardiovascular care unit were divided into three groups: (a) patients diagnosed with TS, (b) females with anterior MI, and (c) other all-comer STEMIs. A 10-point scoring system was used: stressful events (three points), female gender (two points), no history of diabetes mellitus (two points), estimated left ventricular ejection fraction (LVEF) ≤ 40% on admission echocardiography (one point), positive troponin on admission (one point), and no smoking (one point). A t-test was applied to the three study groups, sensitivity and specificity testing was performed using the ROC curve method. Results: A total of 1150 patients were included in our study: 54 with TS, 97 females with anterior MI and 999 other all-comer STEMIs. Patients in the TS group were predominantly females with a higher rate of stressful events prior to admission, lower rates of diabetes mellitus and smoking, and lower LVEF% systolic function compared to the STEMI cohort. In a multivariate logistic regression analysis, the average TS scoring system was significantly higher in the TS group compared with the anterior STEMI and all-comer STEMI groups (8.3 vs. 5.7 vs. 3.83, p < 0.001, respectively) with an AUC of 0.83 for TS score ≥ 8. Conclusions: The 10-point TS scoring system is an easy, reliable, and useful diagnostic tool that might help in distinguishing patients with TS and ACS.
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Deeb et al. (2025) conducted a cohort in Takotsubo syndrome (n=1,150). 10-point Takotsubo syndrome scoring system vs. Anterior MI and all-comer STEMI was evaluated on Average TS score (AUC 0.83, p=<0.001). The 10-point Takotsubo syndrome scoring system yielded significantly higher scores in TS patients compared to anterior STEMI and all-comer STEMI (8.3 vs. 5.7 vs. 3.83, P<0.001), with an AUC of 0.83.
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