Palm Pernille, Wallach-Kildemoes Helle, Bang Lia Evi, Berg Selina Kikkenborg
Department of Cardiology, Copenhagen University hospital Rigshospitalet, Copenhagen, Denmark.
Department of Clinical Medicine, Faculty of Health Science, University of Copenhagen, Copenhagen, Denmark.
Cardiology. 2025 Mar 21:1-13. doi: 10.1159/000543668.
While Takotsubo syndrome (TTS) is less common in men, their mortality rates surpass those of women. The influence of socioeconomic factors and psychological distress remains unexplored. This study aimed to investigate gender differences in socioeconomic profiles and psychological distress among patients with incident TTS and to examine gender differences in survival after discharge, accounting for socioeconomic and psychological factors.
A nationwide cohort study using national registers included all patients discharged from Danish hospitals with an incident TTS diagnosis were eligible. Socioeconomic factors, including marital status, cohabitation status, labour market attachment, highest formal education, family income, and psychological distress, were assessed and compared. Cox regression models were applied to analyse the data.
Of 662 patients with TTS discharged alive 79 (11.9%) were men with a median age of 67 years (interquartile range: 62-77). Men with TTS were socioeconomically disadvantaged compared to women. Unadjusted analyses indicated that male gender was associated with increased mortality (hazard ratio [HR]: 2.61, 95% confidence interval [CI]: 1.18-3.25, p = 0.009). Low income, living alone, being widowed, and receiving a retirement pension were all significantly associated with 3-year mortality risk. However, in the main adjusted model, aside from the gender difference, only the Charlson comorbidity index was significantly associated with a higher mortality risk (HR: 1.26, 95% CI: 1.15-1.39, p < 0.001). No significant interactions between gender and socioeconomic variables were observed.
Men with TTS experienced greater socioeconomic disadvantages and higher 3-year mortality than women, with comorbidity scores significantly influencing outcomes in both genders.
虽然应激性心肌病（TTS）在男性中不太常见，但其死亡率超过女性。社会经济因素和心理困扰的影响仍未得到探索。本研究旨在调查新发TTS患者社会经济状况和心理困扰的性别差异，并在考虑社会经济和心理因素的情况下，研究出院后生存情况的性别差异。
一项使用国家登记册的全国队列研究纳入了所有从丹麦医院出院且诊断为新发TTS的患者。评估并比较了社会经济因素，包括婚姻状况、同居状况、劳动力市场参与度、最高正规教育程度、家庭收入和心理困扰。应用Cox回归模型分析数据。
在662例存活出院的TTS患者中，79例（11.9%）为男性，中位年龄为67岁（四分位间距：62 - 77岁）。与女性相比，患TTS的男性在社会经济方面处于劣势。未经调整的分析表明，男性性别与死亡率增加相关（风险比[HR]：2.61，95%置信区间[CI]：1.18 - 3.25，p = 0.009）。低收入、独居、丧偶和领取退休金均与3年死亡风险显著相关。然而，在主要的调整模型中，除了性别差异外，只有查尔森合并症指数与较高的死亡风险显著相关（HR：1.26，95% CI：1.15 - 1.39，p < 0.001）。未观察到性别与社会经济变量之间的显著相互作用。
与女性相比，患TTS的男性经历了更大的社会经济劣势和更高的3年死亡率，合并症评分对两性的预后均有显著影响。
