Comparison of clinical features and outcomes of Chinese patients with Takotsubo syndrome and acute myocardial infarction—results from the first Chinese Takotsubo syndrome registry

Background: Takotsubo syndrome (TTS) differs significantly from acute myocardial infarction (AMI) in clinical features and pathological mechanisms, but evidence in Asian populations remains limited. The aim of this study is to compare clinical features and outcomes between patients with TTS and AMI in the first Chinese registry of TTS (ChiTTS Registry, ChiCTR1900026725). Time-to-event analysis employed Kaplan-Meier/log-rank tests with landmark analysis. Results: 8.9%, P=0.02). In comparison to AMI patients, the landmark analysis confirmed that TTS patients developed more 100-day MACCEs [hazard ratio (HR) 1.87; 95% confidence interval (CI): 1.03-3.37; log-rank test P=0.04] and all-cause mortality (HR 2.07; 95% CI: 1.10-3.91; log-rank test P=0.02). In contrast, no significant difference was found in long-term MACCEs (HR 0.38; 95% CI: 0.13-1.09; log-rank test P=0.06) and all-cause mortality (HR 0.96; 95% CI: 0.31-2.98; log-rank test P=0.94) between TTS and AMI patients. Conclusions: In comparison to AMI patients, Chinese TTS patients developed more in-hospital complications and had a worse short-term prognosis. The cardiovascular issues in TTS patients underscore the need for effective treatment and personalized strategies to enhance outcomes and mitigate risks.