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Background Takotsubo Syndrome (TTS) is an acute reversible left ventricular dysfunction. Recently published studies have highlighted a similar mortality rate as acute coronary syndrome (ACS). We compared the impact of gender differences on the outcome of TTS patients as compared to ACS patient. Design and methods We included a collective of 138 patients TTS between 2003 and 2016 at our institution. Patients were divided according to their gender into two groups (Males n =21, 15% and females, n =117, 85%). They were compared with a cohort of 300 patients with a diagnosis of ACS. Results On the acute phase, in male patients with TTS, a treatment with inotropic was more often required (33.3 vs. 11.5%, P <0.01), were more susceptible to cardiogenic shock (28.6 vs. 12.5%, P <0.04). Concerning the long-term prognosis after the acute event, male patients had higher all-cause mortality over long-term follow-up. A Kaplan–Meier analysis indicated that the mortality of male patients with TTS was significantly higher compared to male patients with ACS (log-rank <0.01), while there was no significant difference between female patients with TTS and ACS (log-rank =0.60, P =0.45). In a multivariate cox regression analysis, male gender (HR 2.7, 95% CI: 1.1–6.5, P =0.02) GFR <60 ml/min (HR 2.8, 95% CI: 1.2–6.0, P =0.01) and history of cancer (HR 3.6, 95% CI 1.4–9.3, P <0.01) were independent predictors of 5-year mortality. Conclusions Considerable evidence suggests that TTS compared to ACS implicates more significant clinical short-term events on male patients and it may be associated with poorer long-term prognosis. [ABSTRACT FROM AUTHOR]

Background: The pathophysiology of takotsubo syndrome (TTS) is unclear so far. There is strong association of the occurrence of TTS and malignant diseases. An association between malignant diseases and myocardial infarction (MI) was found recently and ascribed to common molecular and lifestyle mechanisms. Aim: To compare the outcome of patients with MI or TTS and malignant diseases in a matched cohort. Methods: Patients with TTS or with MI (n=138 per group) were matched for age and sex and assessed retrospectively and prospectively. Occurrence of malignant diseases and clinical outcome was followed up over 4 years. Results: At the time of the index event, 8 (5.8%) MI patients and 17 (12.3%) TTS patients were already diagnosed with cancer. During follow up, the rate of patients who developed cancer was significantly higher in the TTS group than in the MI group (log rank P=0.01). Mortality was higher in the TTS group, but also in the subgroup of TTS patients with cancer (log rank P<0.05). In the multivariate analysis, male gender, renal impairment and the history of cancer was associated with an increased risk for death. Conclusions: Patients with TTS have more often malignant diseases than patients with MI. Cancer patients with TTS have a worse clinical outcome. The underlying mechanism is unclear yet, but the results point at TTS being the syndrome of an extracardiac disease rather than a disease of cardiac origin. Longer and closer follow up of patients with TTS and further studies addressing the mechanism of TTS are needed. [ABSTRACT FROM AUTHOR]