Gender differences in patients with takotsubo cardiomyopathy: Multi-center registry from Tokyo CCU Network

Tsutomu Murakami, Tsutomu Yoshikawa, Yuichiro Maekawa, Tetsuro Ueda, Toshiaki Isogai, Konomi Sakata, Ken Nagao, Takeshi Yamamoto, Morimasa Takayama

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Background: The clinical features of gender differences in takotsubo cardiomyopathy (TC) remain to be determined. The aim of this study was to evaluate the differences in clinical characteristics of male and female patients with TC. Methods: We obtained the clinical information of 368 patients diagnosed with TC (84 male, 284 female) from the Tokyo CCU Network database collected from 1 January 2010 to 31 December 2012; the Network is comprised of 71 cardiovascular centers in the Tokyo (Japan) metropolitan area. We attempted to characterize clinical differences during hospitalization, comparing male and female patients with TC. Results: There were no significant differences in apical ballooning type, median echocardiography ejection fraction, serious ventricular arrhythmias (such as ventricular tachycardia or fibrillation), or cardiovascular death between male and female patients. Male patients were younger than female patients (median age at hospitalization for male patients was 72 years vs. 76 years for female patients; p = 0.040). Prior physical stress was more common in male than female patients (50.0% vs.31.3%; p = 0.002), while emotional stress was more common in female patients (19.0% vs. 31.0%; p = 0.039). Severe pump failure (defined as Killip Class ≥ III) (20.2% vs. 10.6%; p = 0.020) and cardiopulmonary supportive therapies (28.6% vs. 12.7%, p <0.001) were more common in male than female patients. Multivariate analysis revealed that male gender (odds ratio = 4.32, 95% CI = 1.41-13.6, p = 0.011) was an independent predictor of adverse composite cardiac events, including cardiovascular death, severe pump failure, and serious ventricular arrhythmia. Conclusions: Cardiac complications in our dataset appeared to be more common in male than female patients with TC during their hospitalization. Further investigation is required to clarify the underlying mechanisms responsible for the observed gender differences.

Original languageEnglish
Article numbere0136655
JournalPLoS One
Volume10
Issue number8
DOIs
Publication statusPublished - 2015 Aug 28
Externally publishedYes

Fingerprint

Takotsubo Cardiomyopathy
Tokyo
cardiomyopathy
gender differences
Registries
Pumps
Echocardiography
Composite materials
Hospitalization
arrhythmia
pumps
Cardiac Arrhythmias
death
echocardiography
Ventricular Fibrillation
Ventricular Tachycardia
Psychological Stress
Stroke Volume
odds ratio
multivariate analysis

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

Murakami, T., Yoshikawa, T., Maekawa, Y., Ueda, T., Isogai, T., Sakata, K., ... Takayama, M. (2015). Gender differences in patients with takotsubo cardiomyopathy: Multi-center registry from Tokyo CCU Network. PLoS One, 10(8), [e0136655]. https://doi.org/10.1371/journal.pone.0136655

Gender differences in patients with takotsubo cardiomyopathy : Multi-center registry from Tokyo CCU Network. / Murakami, Tsutomu; Yoshikawa, Tsutomu; Maekawa, Yuichiro; Ueda, Tetsuro; Isogai, Toshiaki; Sakata, Konomi; Nagao, Ken; Yamamoto, Takeshi; Takayama, Morimasa.

In: PLoS One, Vol. 10, No. 8, e0136655, 28.08.2015.

Research output: Contribution to journalArticle

Murakami, T, Yoshikawa, T, Maekawa, Y, Ueda, T, Isogai, T, Sakata, K, Nagao, K, Yamamoto, T & Takayama, M 2015, 'Gender differences in patients with takotsubo cardiomyopathy: Multi-center registry from Tokyo CCU Network', PLoS One, vol. 10, no. 8, e0136655. https://doi.org/10.1371/journal.pone.0136655
Murakami, Tsutomu ; Yoshikawa, Tsutomu ; Maekawa, Yuichiro ; Ueda, Tetsuro ; Isogai, Toshiaki ; Sakata, Konomi ; Nagao, Ken ; Yamamoto, Takeshi ; Takayama, Morimasa. / Gender differences in patients with takotsubo cardiomyopathy : Multi-center registry from Tokyo CCU Network. In: PLoS One. 2015 ; Vol. 10, No. 8.
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abstract = "Background: The clinical features of gender differences in takotsubo cardiomyopathy (TC) remain to be determined. The aim of this study was to evaluate the differences in clinical characteristics of male and female patients with TC. Methods: We obtained the clinical information of 368 patients diagnosed with TC (84 male, 284 female) from the Tokyo CCU Network database collected from 1 January 2010 to 31 December 2012; the Network is comprised of 71 cardiovascular centers in the Tokyo (Japan) metropolitan area. We attempted to characterize clinical differences during hospitalization, comparing male and female patients with TC. Results: There were no significant differences in apical ballooning type, median echocardiography ejection fraction, serious ventricular arrhythmias (such as ventricular tachycardia or fibrillation), or cardiovascular death between male and female patients. Male patients were younger than female patients (median age at hospitalization for male patients was 72 years vs. 76 years for female patients; p = 0.040). Prior physical stress was more common in male than female patients (50.0{\%} vs.31.3{\%}; p = 0.002), while emotional stress was more common in female patients (19.0{\%} vs. 31.0{\%}; p = 0.039). Severe pump failure (defined as Killip Class ≥ III) (20.2{\%} vs. 10.6{\%}; p = 0.020) and cardiopulmonary supportive therapies (28.6{\%} vs. 12.7{\%}, p <0.001) were more common in male than female patients. Multivariate analysis revealed that male gender (odds ratio = 4.32, 95{\%} CI = 1.41-13.6, p = 0.011) was an independent predictor of adverse composite cardiac events, including cardiovascular death, severe pump failure, and serious ventricular arrhythmia. Conclusions: Cardiac complications in our dataset appeared to be more common in male than female patients with TC during their hospitalization. Further investigation is required to clarify the underlying mechanisms responsible for the observed gender differences.",
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AU - Isogai, Toshiaki

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