Key result
Male sex in Takotsubo syndrome is linked to ~157% higher in-hospital mortality compared to females.
Why the study?
Circadian and seasonal variations and potential sex-based differences in Japanese patients with Takotsubo syndrome remained to be clarified.
Observational (n=344)
Yes
Absolute Event Rate: 18% vs 7%
p-value: p=0.005
Takotsubo syndrome exhibits distinct sex-based differences, with males experiencing higher in-hospital mortality and lacking the seasonal variation seen in females, though both sexes show a peak incidence in the afternoon.
May signal higher mortality risk in males with Takotsubo syndrome; leaves open mechanisms and seasonal patterns for prospective validation.
Objective The aim of this study was to clarify the circadian and seasonal variations in addition to identify sex-based differences in Japanese patients with Takotsubo syndrome (TTS). Methods The authors conducted a retrospective observational study to analyse the differences between the groups based on sex. Patients The patients were registered out of each institute registry of the acute coronary syndrome (ACS) which contains a total of 10,622 cases in eight academic hospitals in east Japan. Results Data for 344 consecutive TTS (73 male and 271 female) were extracted from each hospital registry. In-hospital mortality was higher in the male group than in the female group (18% vs. 7%; p=0.005). With regard to the circadian variations in all study patients, TTS events occurred most often in the afternoon and least often during the night. Moreover, the patterns of circadian variations in the female and male groups were the same as that of all study patients. TTS events occurred most frequently in the autumn and least often in the spring in the whole study cohort. Moreover, the seasonal variation in the female group showed the same pattern as that of the whole cohort. However, there were no significant seasonal differences in the incidence of TTS in the male group. Conclusion In a multicenter study in Japan, seasonal variation was observed in the female group but not in the male group. Circadian variation was observed in both groups. These results suggested that the pathogenesis and clinical features of TTS might therefore differ according to sex.
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Yoshizawa et al. (2021) conducted an observational in Takotsubo syndrome (n=344). Male sex vs. Female sex was evaluated on In-hospital mortality (p=0.005). Male patients with Takotsubo syndrome had significantly higher in-hospital mortality compared to female patients (18% vs. 7%, p=0.005), and seasonal variations in incidence were observed only in females.
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