title: Gender Differences in Patients with Takotsubo Cardiomyopathy: Multi-Center Registry from Tokyo CCU Network.
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.
authors: The Tokyo CCU Network Scientific Committee, Tokyo, Japan.
authors: Tsutomu
authors: T
authors: Murakami
authors: The Tokyo CCU Network Scientific Committee, Tokyo, Japan.
authors: Tsutomu
authors: T
authors: Yoshikawa
authors: The Tokyo CCU Network Scientific Committee, Tokyo, Japan.
authors: Yuichiro
authors: Y
authors: Maekawa
authors: The Tokyo CCU Network Scientific Committee, Tokyo, Japan.
authors: Tetsuro
authors: T
authors: Ueda
authors: The Tokyo CCU Network Scientific Committee, Tokyo, Japan.
authors: Toshiaki
authors: T
authors: Isogai
authors: The Tokyo CCU Network Scientific Committee, Tokyo, Japan.
authors: Konomi
authors: K
authors: Sakata
authors: The Tokyo CCU Network Scientific Committee, Tokyo, Japan.
authors: Ken
authors: K
authors: Nagao
authors: The Tokyo CCU Network Scientific Committee, Tokyo, Japan.
authors: Takeshi
authors: T
authors: Yamamoto
authors: The Tokyo CCU Network Scientific Committee, Tokyo, Japan.
authors: Morimasa
authors: M
authors: Takayama
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D012042:Registries / Q000706:statistics & numerical data; D012737:Sex Factors; D054549:Takotsubo Cardiomyopathy / Q000453:epidemiology*