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Ethnic comparison in takotsubo syndrome: novel insights from the International Takotsubo Registry
Journal article   Open access   Peer reviewed

Ethnic comparison in takotsubo syndrome: novel insights from the International Takotsubo Registry

Yoichi Imori, Ken Kato, Victoria L Cammann, Konrad A Szawan, Manfred Wischnewsky, Sara Dreiding, Michael Würdinger, Maximilian Schönberger, Vanya Petkova, David Niederseer, …
Clinical research in cardiology, Vol.111(2), pp.186-196
02/2022
DOI: 10.1007/s00392-021-01857-4
PMCID: PMC8816760
PMID: 34013386
url
https://doi.org/10.1007/s00392-021-01857-4View
Published (Version of record) Open Access

Abstract

Ethnic disparities have been reported in cardiovascular disease. However, ethnic disparities in takotsubo syndrome (TTS) remain elusive. This study assessed differences in clinical characteristics between Japanese and European TTS patients and determined the impact of ethnicity on in-hospital outcomes. TTS patients in Japan were enrolled from 10 hospitals and TTS patients in Europe were enrolled from 32 hospitals participating in the International Takotsubo Registry. Clinical characteristics and in-hospital outcomes were compared between Japanese and European patients. A total of 503 Japanese and 1670 European patients were included. Japanese patients were older (72.6 ± 11.4 years vs. 68.0 ± 12.0 years; p < 0.001) and more likely to be male (18.5 vs. 8.4%; p < 0.001) than European TTS patients. Physical triggering factors were more common (45.5 vs. 32.0%; p < 0.001), and emotional triggers less common (17.5 vs. 31.5%; p < 0.001), in Japanese patients than in European patients. Japanese patients were more likely to experience cardiogenic shock during the acute phase (15.5 vs. 9.0%; p < 0.001) and had a higher in-hospital mortality (8.2 vs. 3.2%; p < 0.001). However, ethnicity itself did not appear to have an impact on in-hospital mortality. Machine learning approach revealed that the presence of physical stressors was the most important prognostic factor in both Japanese and European TTS patients. Differences in clinical characteristics and in-hospital outcomes between Japanese and European TTS patients exist. Ethnicity does not impact the outcome in TTS patients. The worse in-hospital outcome in Japanese patients, is mainly driven by the higher prevalence of physical triggers. URL: https://www.clinicaltrials.gov ; Unique Identifier: NCT01947621.
 Aged Asians - ethnology Asians - statistics & numerical data Europe - epidemiology Female Health Status Disparities Hospital Mortality - ethnology Humans Japan - epidemiology Male Middle Aged Prevalence Registries Shock, Cardiogenic - ethnology Shock, Cardiogenic - mortality Takotsubo Cardiomyopathy - ethnology Takotsubo Cardiomyopathy - mortality Whites - ethnology Whites - statistics & numerical data

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