Morbidity after Takotsubo Syndrome A report from the Scottish Takotsubo Registry

Takotsubo syndrome is characterised by transient left ventricular dysfunction, often precipitated by intense emotional or physical stress. Although its clinical presentation is like acute myocardial infarction, there is no culprit or obstructive coronary artery disease on coronary angiography. After the acute phase, the left ventricular ejection fraction fully recovers (1). Despite this, several registries have reported (2-4) reduced long-term survival after an episode of acute takotsubo syndrome. The Scottish Takotsubo Registry showed this reduced long-term survival to be specifically attributable to cardiovascular mortality (4). However, the extent and causes of subsequent morbidity following recovery after takotsubo syndrome episode are unknown. Here, we explored the incidence and causes of all subsequent hospital readmissions affecting patients with takotsubo syndrome.

The Scottish Takotsubo Registry records all (unselected) cases of takotsubo syndrome patients diagnosed in Scotland from 1st of January 2010 (clinicaltrials.gov: NCT03299569). This cohort study reports on patients diagnosed until 31st December 2017 and followed up until death or 31st May 2021, whichever was earliest. Nearest neighbour matching was used to select age, sex and geographically matched Scottish general population control subjects (1:4, n=2480) and patients with acute myocardial infarction (1:1, n=620) from the High-STEACS population (NCT01852123) (4-5).
Demographic and clinical characteristics of the current cohort were previously published (4-5). Electronic data linkage connected the unique Community Health Index number of each subject with the Public Health Scotland national database using International Classification of Diseases, Tenth Revision (ICD-10) diagnosis codes and included all hospital admission episodes.