title: Characterization of Tako-tsubo Cardiomyopathy in Spain: Results from the RETAKO National Registry.
abstract: OBJECTIVE
  The etiology and epidemiology of tako-tsubo cardiomyopathy remain uncertain. The symptoms of this condition are often similar to those of myocardial infarction and, although it usually has a good prognosis, it is not without complications. Our aim was to characterize this disease in our setting using a dedicated registry (Spanish REgistry for TAKOtsubo cardiomyopathy).
  
  
  METHODS
  The prospective registry included 202 incident patients in 23 hospitals from 2012 to 2013. The patients' clinical characteristics and analytical, echocardiographic, and imaging results were recorded, as were the events during follow-up. Patients were included when the attending physician considered the case proven, and incidence was calculated relative to the catheterizations requested for a presumptive diagnosis of acute coronary syndrome.
  
  
  RESULTS
  The patients were predominantly women (90%), with a mean age of 70 years, and many had cardiovascular risk factors, such as hypertension (67%), dyslipidemia (41%), diabetes mellitus (15%), and smoking (15%). The incidence of tako-tsubo cardiomyopathy was 1.2%, and there was no clear weekly or seasonal distribution pattern. Chest pain was the predominant symptom, a triggering factor (emotional, physical, or both) was present in 72%, and most patients consulted within the first 6h after symptom onset. The median duration of hospitalization was 7 days. There were heart failure symptoms in 34.0%, arrhythmia in 26.7%, and 2.4% of patients died.
  
  
  CONCLUSIONS
  The incidence of tako-tsubo cardiomyopathy is low. This disease primarily affects postmenopausal women, and occurs after a situation of emotional stress in more than half of affected individuals. It is characterized by anginal pain, shows no seasonal distribution, and has a good prognosis, although it is not without morbidity and mortality.
authors.affiliation: Instituto Cardiovascular, Hospital Clínico San Carlos, Madrid, Spain. Electronic address: ibnsky@yahoo.es.
authors.forename: Iván J
authors.initials: IJ
authors.lastname: Núñez Gil
authors.affiliation: Servicio de Cardiología, Hospital Vall d'Hebron, Barcelona, Spain.
authors.forename: Mireia
authors.initials: M
authors.lastname: Andrés
authors.affiliation: Servicio de Cardiología, Hospital Virgen Macarena, Seville, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Almendro Delia
authors.affiliation: Unidad de Cuidados Intensivos Cardiológicos, Servicio de Cardiología, Hospital de Sant Pau, Instituto de Investigación Biomédica Sant Pau (IIB Sant Pau), Barcelona, Spain.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Sionis
authors.affiliation: Servicio de Cardiología, Hospital Universitario de Salamanca, Salamanca, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Martín
authors.affiliation: Servicio de Cardiología, Hospital Universitario de la Princesa, Madrid, Spain.
authors.forename: Teresa
authors.initials: T
authors.lastname: Bastante
authors.affiliation: Servicio de Cardiología, Complejo Hospitalario Universitario de Albacete, Albacete, Spain.
authors.forename: Juan Gabriel
authors.initials: JG
authors.lastname: Córdoba Soriano
authors.affiliation: Servicio de Cardiología, Hospital Clínico Lozano Blesa, Zaragoza, Spain.
authors.forename: José A
authors.initials: JA
authors.lastname: Linares Vicente
authors.affiliation: Servicio de Cardiología, Hospital Universitario Arnau de Vilanova, Lerida, Spain.
authors.forename: Silvia
authors.initials: S
authors.lastname: González Sucarrats
authors.affiliation: Servicio de Cardiología, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Sánchez-Grande Flecha
mesh_terms: D000368:Aged; D057791:Cardiac Imaging Techniques; D003925:Diabetic Angiopathies / Q000150:complications; D050171:Dyslipidemias / Q000150:complications; D004562:Electrocardiography; D004644:Emotions; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D006973:Hypertension / Q000150:complications; D015994:Incidence; D008297:Male; D011446:Prospective Studies; D012042:Registries; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D013030:Spain / Q000453:epidemiology; D013315:Stress, Psychological / Q000150:complications; D054549:Takotsubo Cardiomyopathy / Q000453:epidemiology* / Q000209:etiology
keywords: Acute coronary syndrome; Epidemiology; Epidemiología; Infarct; Infarto; Prognosis; Pronóstico; Registro; Registry; Síndrome coronario agudo; Síndrome de tako-tsubo; Tako-tsubo cardiomyopathy