Résumé
Background: takotsubo syndrome (TTS) predominantly affects postmenopausal women (90% of TTS) and data lack for men and younger women with TTS.Objectives: to compare clinical characteristics and outcomes from men of all age and young women (<60 years) to older women (≥60 years) with TTS, then find predictive factors of death, cardiogenic shock, symptomatic heart failure, LVEF ≤35%, and early left ventricular recovery.Methods: from January 2010 to July 2021, we retrospectively included all patients over 18 y-o diagnosed with TTS according to the InterTAK Diagnostic Criteria (2018) at Nîmes hospital. Baseline characteristics, laboratory profile, imaging studies and in hospital complications were collected and compared among the 3 groups. Results: of 301 TTS patients included, 201 were women ≥60 years of age (66,7%), 44 women <60 years 14,6%) and 56 men (18,6%). Mean age at diagnosis was 71 years. Prior physical stress was more common in male (78,6% vs 48,9%) while emotional stress was more common in female patients (37,5% vs 16,1%). Men presented less chest pain but more state of shock (all causes included) at the time of admission. There were no significant differences in laboratory data, echocardiographic and electrocardiographic findings. Symptomatic heart failure was the main complication (43,8%). Cardiogenic shock occured in 10,6% of TTS and multivariate analysis revealed that age <60 years, male gender and symptomatic heart failure were independent predictors of cardiogenic shock. In hospital mortality was 3% regarding all TTS. Conclusion: TTS appear to be more common than expected in male and young women. Men’s clinical presentation are often unusual. Men also present more severe complications. Only few differences exist between young and older women TTS.