Long-term prognosis in Takotsubo syndrome compared to heart failure: observations from a global federated research network

INTRODUCTION: To compare long-term outcomes of patients with Takotsubo syndrome (TTS) and heart failure (HF). METHODS: This retrospective observational study used the TriNetX global federated research network. Adult patients (≥18 years) discharged with a diagnosis of TTS (ICD-10-CM I51.81) or HF (I50.x) between 2018 and 2022 were identified. Primary outcomes were 3-year risk of all-cause death, major adverse cardiovascular events (MACE; myocardial infarction or ischaemic stroke), and acute HF. Secondary outcomes included myocardial infarction, ischaemic stroke, ventricular arrhythmias (ventricular tachycardia), malignant arrhythmias (ventricular fibrillation or cardiac arrest), and new-onset atrial fibrillation (AF). Cox proportional hazards models estimated hazard ratios (HRs) with 95% confidence intervals (CIs) before and after 1:1 propensity score matching (PSM). Subgroup analyses were performed by HF phenotype, age (≥65 vs