Cardiogenic Shock Complicating Takotsubo Syndrome: Sex‐Related Differences

Abstract

Background Sex‐related differences in Takotsubo syndrome have been described, but no information is available in patients who develop cardiogenic shock. Methods and Results Of 412 patients with Takotsubo syndrome with cardiogenic shock, 71 (17.2%) were men. Male patients were older (71.1±12.2 versus 65.3±17.1 years, P<0.001), more frequently smokers (47 [66.2%] versus 66 [19.4%], P<0.01), with higher prevalence of neoplasms (6 [8.5%] versus 8 [2.3%], P=0.01), lower left ventricular ejection fraction (31% versus 37%, P<0.001), more frequent invasive mechanical ventilation (30 [42.3%] versus 90 [26.4%], P=<0.01), higher rate of infections (43 [60.6%] versus 148 [43.4%], P=<0.01), and longer in‐hospital stay (19±20 days versus 13±15 days, P=0.02). A total of 55 patients (13.3%) died during hospital admission, and 90 patients (21.8%) died at the end of the 5‐year follow‐up. Male sex was not significantly associated with the in‐hospital (odds ratio, 1.31 [95% CI, 0.64–2.68]) or 5‐year mortality rate (hazard ratio, 1.66 [95% CI, 0.93–2.94]). In the matched cohort, no significant differences in the short‐ and long‐term mortality rate were found either. Conclusions Cardiogenic shock due to Takotsubo syndrome has high short‐ and long‐term mortality rates that are similar in men and women.

Keywords

• cardiogenic shock
• heart failure
• prognosis
• sex
• Takotsubo