Validation of Takotsubo Syndrome Scoring System

<b>Background</b>: Takotsubo syndrome (TS) mimics acute coronary syndrome in 1% to 3% of patients presenting with chest pain, ECG changes and echocardiographic transient apical wall hypokinesia. <b>Objectives</b>: This study aimed to validate a previously developed scoring sy...

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Main Authors: Dana Deeb, Ranel Loutati, Louay Taha, Mohammad Karmi, Akiva Brin, Ofir Rabi, Nir Levi, Noam Fink, Pierre Sabouret, Mohammed Manassra, Abed Qadan, Motaz Amro, Benyamin Khalev, Michael Glikson, Elad Asher
Format: Article
Language:English
Published: MDPI AG 2025-05-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/15/11/1314
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Summary:<b>Background</b>: Takotsubo syndrome (TS) mimics acute coronary syndrome in 1% to 3% of patients presenting with chest pain, ECG changes and echocardiographic transient apical wall hypokinesia. <b>Objectives</b>: This study aimed to validate a previously developed scoring system on a larger cohort size. <b>Methods</b>: Patients admitted to an intensive cardiovascular care unit were divided into three groups: (a) patients diagnosed with TS, (b) females with anterior MI, and (c) other all-comer STEMIs. A 10-point scoring system was used: stressful events (three points), female gender (two points), no history of diabetes mellitus (two points), estimated left ventricular ejection fraction (LVEF) ≤ 40% on admission echocardiography (one point), positive troponin on admission (one point), and no smoking (one point). A <i>t</i>-test was applied to the three study groups, sensitivity and specificity testing was performed using the ROC curve method. <b>Results</b>: A total of 1150 patients were included in our study: 54 with TS, 97 females with anterior MI and 999 other all-comer STEMIs. Patients in the TS group were predominantly females with a higher rate of stressful events prior to admission, lower rates of diabetes mellitus and smoking, and lower LVEF% systolic function compared to the STEMI cohort. In a multivariate logistic regression analysis, the average TS scoring system was significantly higher in the TS group compared with the anterior STEMI and all-comer STEMI groups (8.3 vs. 5.7 vs. 3.83, <i>p</i> < 0.001, respectively) with an AUC of 0.83 for TS score ≥ 8. <b>Conclusions</b>: The 10-point TS scoring system is an easy, reliable, and useful diagnostic tool that might help in distinguishing patients with TS and ACS.
ISSN:2075-4418