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.