Maskoun, WaddahAlqam, BilalHabash, FuadGheith, ZaidSawada, Stephen G.Vallurupalli, Srikanth2023-11-202023-11-202022-11-18Maskoun W, Alqam B, Habash F, Gheith Z, Sawada SG, Vallurupalli S. Sex Differences in Stress-Induced (Takotsubo) Cardiomyopathy. CJC Open. 2022;5(2):120-127. Published 2022 Nov 18. doi:10.1016/j.cjco.2022.11.012https://hdl.handle.net/1805/37165Background: Takotsubo cardiomyopathy (TC) affects predominantly women. Prior studies have suggested that men might have worse short-term outcomes, but limited data are available regarding long-term outcomes. We hypothesized that men, compared to women, with TC have worse short- and long-term outcomes. Methods: A retrospective study of patients diagnosed with TC between 2005 and 2018 in the Veteran Affairs system was performed. Primary outcomes were in-hospital death, 30-day risk of stroke, death, and long-term mortality. Results: A total of 641 patients were included (444 men [69%]; 197 women [31%]). Men had a higher median age (65 vs 60 years; P < 0.001), and women were more likely to present with chest pain (68.7% vs 44.1%; P < 0.001). Physical triggers were more common in men (68.7% vs 44.1%, P < 0.001). Men had a higher in-hospital mortality rate (8.1% vs 1%; P < 0.001). On multivariable regression analysis, female sex was an independent predictor for improved in-hospital mortality, compared to men (odds ratio 0.25, 95% confidence interval 0.06-1.10; P = 0.04). On 30-day follow-up, no difference occurred in a combined outcome of stroke and death (3.9% vs 1.5%; P = 0.12). On long-term follow-up (3.7 ± 3.1 years), female sex was identified as an independent predictor of lower mortality (hazard ratio 0.71, 95% CI 0.51-0.97; P = 0.032). Women were more likely to have TC recurrence (3.6% vs 1.1%; P = 0.04). Conclusions: In our study with a predominantly male population, men had less-favourable short- and long-term outcomes after TC, compared to those of women.en-USAttribution-NonCommercial-NoDerivatives 4.0 InternationalTakotsubo cardiomyopathyMultivariable regression analysisIn-hospital mortalityLong-term outcomesArticle