Comparison of Takotsubo syndrome with acute myocardial infarction in Spain using hospital discharge data (MBDS)

OBJECTIVE To compare the profiles and outcomes of patients with Takotsubo syndrome (TTS) and acute myocardial infarction (AMI). DESIGN A retrospective observational study (2016-2022). Multilevel risk adjustments. SETTING Acute hospitals of the Spanish National Health System (SNS). PATIENTS Hospitalization episodes using the SNS Minimum Basic Data Set (MBDS). INTERVENTIONS TTS episodes without a recorded imaging procedure were excluded. VARIABLES OF INTEREST Crude and risk-adjusted hospital mortality and readmissions at 30 days due to circulatory causes. RESULTS 4,112 TTS episodes and 275,835 AMI episodes were identified. Significant differences were observed in terms of age, gender, and associated comorbidities. The crude hospital mortality rate was 2.9% for TTS episodes compared to 7.2% for AMI episodes (p < 0.001). After adjusting for confounders, the risks of mortality (OR: 0.34; CI: 0.28-0.41; p < 0.01) and readmission in the first month due to circulatory system diseases (OR: 0.48; CI: 0.39-0.6; p < 0.01) were significantly lower in patients with TTS. The predictors of mortality and hospital readmission differed between the two disorders. CONCLUSIONS TTS differs from AMI in its clinical characteristics. Risk-adjusted hospital mortality and 30-day readmissions due to circulatory causes were lower in patients with TTS than in those with AMI.