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Survival and risk of recurrence of takotsubo syndrome
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  • Published on:
    Takotsubo Cardiomyopathy; A Tale of Two Distinct Etiologies
    • Nausharwan Butt, Resident Physician Section of Internal Medicine, MedStar Washington Hospital Center, Washington, DC, 20010, USA
    • Other Contributors:
      • Nauman Khalid, Interventional Cardiologist
      • Anna Ong, Physician
      • Asma Gulab, Resident Physician
      • Sarah A Ahmad, Cardiothoracic Surgeon
      • Lovely Chhabra, Interventional Cardiologist

    To the Editor,

    In an excellent analysis published in the recent issue of the journal, “Heart” Lau et al. investigated the long-term clinic outcomes of patients with Takotsubo syndrome (TTS) in a large cohort. The results demonstrated that increasing age, male gender, diabetes mellitus, pulmonary disease and chronic kidney disease were associated with a higher risk of recurrence or death1. We wish to highlight a few points relevant to the article.

    Núñez-Gil et al reported their findings whilst categorizing patients with TTS based upon proposed etiology. Individuals with idiopathic or emotional triggers were considered as having the primary disease, whereas those with likely physical causative factors were deemed to have a secondary form of the pathology. The analysis of both groups revealed a disparity in clinical outcomes; patients with underlying physical triggers displayed higher risk of both short and long-term adverse events 2. Similar findings have also been reported in other studies 3.

    Prior published data has theorized that a history of diabetes mellitus may be relatively protective against developed of TTS possibly due to an ameliorated sympathetic response when compared to non-diabetics due to involvement related to diabetic neuropathy 4. Comparatively poorer outcomes in diabetic TTS patients as seen in this study may be possibly explained by the fact that these diabetic patients may have been overwhelmingly sicker to generate enough catecho...

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    Conflict of Interest:
    None declared.