Ethnic comparison in takotsubo syndrome: novel insights from the International Takotsubo Registry

Yoichi Imori; Ken Kato; Victoria L. Cammann; Konrad A. Szawan; Manfred Wischnewsky; Sara Dreiding; Michael Würdinger; Maximilian Schönberger; Vanya Petkova; David Niederseer; Rena A. Levinson; Davide Di Vece; Sebastiano Gili; Burkhardt Seifert; Masaki Wakita; Noriko Suzuki; Rodolfo Citro; Eduardo Bossone; Susanne Heiner; Maike Knorr; Thomas Jansen; Thomas Münzel; Fabrizio D’Ascenzo; Jennifer Franke; Ioana Sorici-Barb; Hugo A. Katus; Annahita Sarcon; Jerold Shinbane; L. Christian Napp; Johann Bauersachs; Milosz Jaguszewski; Reiko Shiomura; Shunichi Nakamura; Hitoshi Takano; Michel Noutsias; Christof Burgdorf; Iwao Ishibashi; Toshiharu Himi; Wolfgang Koenig; Heribert Schunkert; Holger Thiele; Behrouz Kherad; Carsten Tschöpe; Burkert M. Pieske; Lawrence Rajan; Guido Michels; Roman Pfister; Shingo Mizuno; Alessandro Cuneo; Claudius Jacobshagen; Gerd Hasenfuß; Mahir Karakas; Hiroki Mochizuki; Alexander Pott; Wolfgang Rottbauer; Samir M. Said; Ruediger C. Braun-Dullaeus; Adrian Banning; Toshiaki Isogai; Akihisa Kimura; Florim Cuculi; Richard Kobza; Thomas A. Fischer; Tuija Vasankari; K. E.Juhani Airaksinen; Yasuhiro Tomita; Monika Budnik; Grzegorz Opolski; Rafal Dworakowski; Philip MacCarthy; Christoph Kaiser; Stefan Osswald; Leonarda Galiuto; Filippo Crea; Wolfgang Dichtl; Tsutomu Murakami; Yuji Ikari; Klaus Empen; Daniel Beug; Stephan B. Felix; Clément Delmas; Olivier Lairez; Tetsuo Yamaguchi; Ibrahim El-Battrawy; Ibrahim Akin; Martin Borggrefe; John D. Horowitz; Martin Kozel; Petr Tousek; Petr Widimský; Ekaterina Gilyarova; Alexandra Shilova; Mikhail Gilyarov; Michael Neuhaus; Philippe Meyer; Jose David Arroja; Christina Chan; Paul Bridgman; Jan Galuszka; Gregor Poglajen; Pedro Carrilho-Ferreira; Fausto J. Pinto; Christian Hauck; Lars S. Maier; Kan Liu; Carlo Di Mario; Carla Paolini; Claudio Bilato; Matteo Bianco; Lucas Jörg; Hans Rickli; David E. Winchester; Christian Ukena; Michael Böhm; Jeroen J. Bax; Abhiram Prasad; Charanjit S. Rihal; Shigeru Saito; Yoshio Kobayashi; Thomas F. Lüscher; Frank Ruschitzka; Wataru Shimizu; Jelena R. Ghadri; Christian Templin

doi:10.1007/s00392-021-01857-4

Ethnic comparison in takotsubo syndrome: novel insights from the International Takotsubo Registry

Yoichi Imori, Ken Kato, Victoria L. Cammann, Konrad A. Szawan, Manfred Wischnewsky, Sara Dreiding, Michael Würdinger, Maximilian Schönberger, Vanya Petkova, David Niederseer, Rena A. Levinson, Davide Di Vece, Sebastiano Gili, Burkhardt Seifert, Masaki Wakita, Noriko Suzuki, Rodolfo Citro, Eduardo Bossone, Susanne Heiner, Maike KnorrThomas Jansen, Thomas Münzel, Fabrizio D’Ascenzo, Jennifer Franke, Ioana Sorici-Barb, Hugo A. Katus, Annahita Sarcon, Jerold Shinbane, L. Christian Napp, Johann Bauersachs, Milosz Jaguszewski, Reiko Shiomura, Shunichi Nakamura, Hitoshi Takano, Michel Noutsias, Christof Burgdorf, Iwao Ishibashi, Toshiharu Himi, Wolfgang Koenig, Heribert Schunkert, Holger Thiele, Behrouz Kherad, Carsten Tschöpe, Burkert M. Pieske, Lawrence Rajan, Guido Michels, Roman Pfister, Shingo Mizuno, Alessandro Cuneo, Claudius Jacobshagen, Gerd Hasenfuß, Mahir Karakas, Hiroki Mochizuki, Alexander Pott, Wolfgang Rottbauer, Samir M. Said, Ruediger C. Braun-Dullaeus, Adrian Banning, Toshiaki Isogai, Akihisa Kimura, Florim Cuculi, Richard Kobza, Thomas A. Fischer, Tuija Vasankari, K. E.Juhani Airaksinen, Yasuhiro Tomita, Monika Budnik, Grzegorz Opolski, Rafal Dworakowski, Philip MacCarthy, Christoph Kaiser, Stefan Osswald, Leonarda Galiuto, Filippo Crea, Wolfgang Dichtl, Tsutomu Murakami, Yuji Ikari, Klaus Empen, Daniel Beug, Stephan B. Felix, Clément Delmas, Olivier Lairez, Tetsuo Yamaguchi, Ibrahim El-Battrawy, Ibrahim Akin, Martin Borggrefe, John D. Horowitz, Martin Kozel, Petr Tousek, Petr Widimský, Ekaterina Gilyarova, Alexandra Shilova, Mikhail Gilyarov, Michael Neuhaus, Philippe Meyer, Jose David Arroja, Christina Chan, Paul Bridgman, Jan Galuszka, Gregor Poglajen, Pedro Carrilho-Ferreira, Fausto J. Pinto, Christian Hauck, Lars S. Maier, Kan Liu, Carlo Di Mario, Carla Paolini, Claudio Bilato, Matteo Bianco, Lucas Jörg, Hans Rickli, David E. Winchester, Christian Ukena, Michael Böhm, Jeroen J. Bax, Abhiram Prasad, Charanjit S. Rihal, Shigeru Saito, Yoshio Kobayashi, Thomas F. Lüscher, Frank Ruschitzka, Wataru Shimizu, Jelena R. Ghadri, Christian Templin

Cardiovascular Medicine

Research output: Contribution to journal › Article › peer-review

Abstract

Background: Ethnic disparities have been reported in cardiovascular disease. However, ethnic disparities in takotsubo syndrome (TTS) remain elusive. This study assessed differences in clinical characteristics between Japanese and European TTS patients and determined the impact of ethnicity on in-hospital outcomes. Methods: TTS patients in Japan were enrolled from 10 hospitals and TTS patients in Europe were enrolled from 32 hospitals participating in the International Takotsubo Registry. Clinical characteristics and in-hospital outcomes were compared between Japanese and European patients. Results: A total of 503 Japanese and 1670 European patients were included. Japanese patients were older (72.6 ± 11.4 years vs. 68.0 ± 12.0 years; p < 0.001) and more likely to be male (18.5 vs. 8.4%; p < 0.001) than European TTS patients. Physical triggering factors were more common (45.5 vs. 32.0%; p < 0.001), and emotional triggers less common (17.5 vs. 31.5%; p < 0.001), in Japanese patients than in European patients. Japanese patients were more likely to experience cardiogenic shock during the acute phase (15.5 vs. 9.0%; p < 0.001) and had a higher in-hospital mortality (8.2 vs. 3.2%; p < 0.001). However, ethnicity itself did not appear to have an impact on in-hospital mortality. Machine learning approach revealed that the presence of physical stressors was the most important prognostic factor in both Japanese and European TTS patients. Conclusion: Differences in clinical characteristics and in-hospital outcomes between Japanese and European TTS patients exist. Ethnicity does not impact the outcome in TTS patients. The worse in-hospital outcome in Japanese patients, is mainly driven by the higher prevalence of physical triggers. Trial Registration: URL: https://www.clinicaltrials.gov; Unique Identifier: NCT01947621.

Original language	English (US)
Pages (from-to)	186-196
Number of pages	11
Journal	Clinical Research in Cardiology
Volume	111
Issue number	2
DOIs	https://doi.org/10.1007/s00392-021-01857-4
State	Published - Feb 2022

Keywords

Broken heart syndrome
Ethnicity
Race
Takotsubo syndrome

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine

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10.1007/s00392-021-01857-4

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Imori, Y., Kato, K., Cammann, V. L., Szawan, K. A., Wischnewsky, M., Dreiding, S., Würdinger, M., Schönberger, M., Petkova, V., Niederseer, D., Levinson, R. A., Di Vece, D., Gili, S., Seifert, B., Wakita, M., Suzuki, N., Citro, R., Bossone, E., Heiner, S., ... Templin, C. (2022). Ethnic comparison in takotsubo syndrome: novel insights from the International Takotsubo Registry. Clinical Research in Cardiology, 111(2), 186-196. https://doi.org/10.1007/s00392-021-01857-4

Imori, Y, Kato, K, Cammann, VL, Szawan, KA, Wischnewsky, M, Dreiding, S, Würdinger, M, Schönberger, M, Petkova, V, Niederseer, D, Levinson, RA, Di Vece, D, Gili, S, Seifert, B, Wakita, M, Suzuki, N, Citro, R, Bossone, E, Heiner, S, Knorr, M, Jansen, T, Münzel, T, D’Ascenzo, F, Franke, J, Sorici-Barb, I, Katus, HA, Sarcon, A, Shinbane, J, Napp, LC, Bauersachs, J, Jaguszewski, M, Shiomura, R, Nakamura, S, Takano, H, Noutsias, M, Burgdorf, C, Ishibashi, I, Himi, T, Koenig, W, Schunkert, H, Thiele, H, Kherad, B, Tschöpe, C, Pieske, BM, Rajan, L, Michels, G, Pfister, R, Mizuno, S, Cuneo, A, Jacobshagen, C, Hasenfuß, G, Karakas, M, Mochizuki, H, Pott, A, Rottbauer, W, Said, SM, Braun-Dullaeus, RC, Banning, A, Isogai, T, Kimura, A, Cuculi, F, Kobza, R, Fischer, TA, Vasankari, T, Airaksinen, KEJ, Tomita, Y, Budnik, M, Opolski, G, Dworakowski, R, MacCarthy, P, Kaiser, C, Osswald, S, Galiuto, L, Crea, F, Dichtl, W, Murakami, T, Ikari, Y, Empen, K, Beug, D, Felix, SB, Delmas, C, Lairez, O, Yamaguchi, T, El-Battrawy, I, Akin, I, Borggrefe, M, Horowitz, JD, Kozel, M, Tousek, P, Widimský, P, Gilyarova, E, Shilova, A, Gilyarov, M, Neuhaus, M, Meyer, P, Arroja, JD, Chan, C, Bridgman, P, Galuszka, J, Poglajen, G, Carrilho-Ferreira, P, Pinto, FJ, Hauck, C, Maier, LS, Liu, K, Di Mario, C, Paolini, C, Bilato, C, Bianco, M, Jörg, L, Rickli, H, Winchester, DE, Ukena, C, Böhm, M, Bax, JJ, Prasad, A, Rihal, CS, Saito, S, Kobayashi, Y, Lüscher, TF, Ruschitzka, F, Shimizu, W, Ghadri, JR & Templin, C 2022, 'Ethnic comparison in takotsubo syndrome: novel insights from the International Takotsubo Registry', Clinical Research in Cardiology, vol. 111, no. 2, pp. 186-196. https://doi.org/10.1007/s00392-021-01857-4

@article{18733236a20c4d9892a4406084efab98,

title = "Ethnic comparison in takotsubo syndrome: novel insights from the International Takotsubo Registry",

abstract = "Background: Ethnic disparities have been reported in cardiovascular disease. However, ethnic disparities in takotsubo syndrome (TTS) remain elusive. This study assessed differences in clinical characteristics between Japanese and European TTS patients and determined the impact of ethnicity on in-hospital outcomes. Methods: TTS patients in Japan were enrolled from 10 hospitals and TTS patients in Europe were enrolled from 32 hospitals participating in the International Takotsubo Registry. Clinical characteristics and in-hospital outcomes were compared between Japanese and European patients. Results: A total of 503 Japanese and 1670 European patients were included. Japanese patients were older (72.6 ± 11.4 years vs. 68.0 ± 12.0 years; p < 0.001) and more likely to be male (18.5 vs. 8.4%; p < 0.001) than European TTS patients. Physical triggering factors were more common (45.5 vs. 32.0%; p < 0.001), and emotional triggers less common (17.5 vs. 31.5%; p < 0.001), in Japanese patients than in European patients. Japanese patients were more likely to experience cardiogenic shock during the acute phase (15.5 vs. 9.0%; p < 0.001) and had a higher in-hospital mortality (8.2 vs. 3.2%; p < 0.001). However, ethnicity itself did not appear to have an impact on in-hospital mortality. Machine learning approach revealed that the presence of physical stressors was the most important prognostic factor in both Japanese and European TTS patients. Conclusion: Differences in clinical characteristics and in-hospital outcomes between Japanese and European TTS patients exist. Ethnicity does not impact the outcome in TTS patients. The worse in-hospital outcome in Japanese patients, is mainly driven by the higher prevalence of physical triggers. Trial Registration: URL: https://www.clinicaltrials.gov; Unique Identifier: NCT01947621.",

keywords = "Broken heart syndrome, Ethnicity, Race, Takotsubo syndrome",

author = "Yoichi Imori and Ken Kato and Cammann, {Victoria L.} and Szawan, {Konrad A.} and Manfred Wischnewsky and Sara Dreiding and Michael W{\"u}rdinger and Maximilian Sch{\"o}nberger and Vanya Petkova and David Niederseer and Levinson, {Rena A.} and {Di Vece}, Davide and Sebastiano Gili and Burkhardt Seifert and Masaki Wakita and Noriko Suzuki and Rodolfo Citro and Eduardo Bossone and Susanne Heiner and Maike Knorr and Thomas Jansen and Thomas M{\"u}nzel and Fabrizio D{\textquoteright}Ascenzo and Jennifer Franke and Ioana Sorici-Barb and Katus, {Hugo A.} and Annahita Sarcon and Jerold Shinbane and Napp, {L. Christian} and Johann Bauersachs and Milosz Jaguszewski and Reiko Shiomura and Shunichi Nakamura and Hitoshi Takano and Michel Noutsias and Christof Burgdorf and Iwao Ishibashi and Toshiharu Himi and Wolfgang Koenig and Heribert Schunkert and Holger Thiele and Behrouz Kherad and Carsten Tsch{\"o}pe and Pieske, {Burkert M.} and Lawrence Rajan and Guido Michels and Roman Pfister and Shingo Mizuno and Alessandro Cuneo and Claudius Jacobshagen and Gerd Hasenfu{\ss} and Mahir Karakas and Hiroki Mochizuki and Alexander Pott and Wolfgang Rottbauer and Said, {Samir M.} and Braun-Dullaeus, {Ruediger C.} and Adrian Banning and Toshiaki Isogai and Akihisa Kimura and Florim Cuculi and Richard Kobza and Fischer, {Thomas A.} and Tuija Vasankari and Airaksinen, {K. E.Juhani} and Yasuhiro Tomita and Monika Budnik and Grzegorz Opolski and Rafal Dworakowski and Philip MacCarthy and Christoph Kaiser and Stefan Osswald and Leonarda Galiuto and Filippo Crea and Wolfgang Dichtl and Tsutomu Murakami and Yuji Ikari and Klaus Empen and Daniel Beug and Felix, {Stephan B.} and Cl{\'e}ment Delmas and Olivier Lairez and Tetsuo Yamaguchi and Ibrahim El-Battrawy and Ibrahim Akin and Martin Borggrefe and Horowitz, {John D.} and Martin Kozel and Petr Tousek and Petr Widimsk{\'y} and Ekaterina Gilyarova and Alexandra Shilova and Mikhail Gilyarov and Michael Neuhaus and Philippe Meyer and Arroja, {Jose David} and Christina Chan and Paul Bridgman and Jan Galuszka and Gregor Poglajen and Pedro Carrilho-Ferreira and Pinto, {Fausto J.} and Christian Hauck and Maier, {Lars S.} and Kan Liu and {Di Mario}, Carlo and Carla Paolini and Claudio Bilato and Matteo Bianco and Lucas J{\"o}rg and Hans Rickli and Winchester, {David E.} and Christian Ukena and Michael B{\"o}hm and Bax, {Jeroen J.} and Abhiram Prasad and Rihal, {Charanjit S.} and Shigeru Saito and Yoshio Kobayashi and L{\"u}scher, {Thomas F.} and Frank Ruschitzka and Wataru Shimizu and Ghadri, {Jelena R.} and Christian Templin",

note = "Publisher Copyright: {\textcopyright} 2021, The Author(s).",

year = "2022",

month = feb,

doi = "10.1007/s00392-021-01857-4",

language = "English (US)",

volume = "111",

pages = "186--196",

journal = "Clinical Research in Cardiology",

issn = "1861-0684",

publisher = "D. Steinkopff-Verlag",

number = "2",

}

TY - JOUR

T1 - Ethnic comparison in takotsubo syndrome

T2 - novel insights from the International Takotsubo Registry

AU - Imori, Yoichi

AU - Kato, Ken

AU - Cammann, Victoria L.

AU - Szawan, Konrad A.

AU - Wischnewsky, Manfred

AU - Dreiding, Sara

AU - Würdinger, Michael

AU - Schönberger, Maximilian

AU - Petkova, Vanya

AU - Niederseer, David

AU - Levinson, Rena A.

AU - Di Vece, Davide

AU - Gili, Sebastiano

AU - Seifert, Burkhardt

AU - Wakita, Masaki

AU - Suzuki, Noriko

AU - Citro, Rodolfo

AU - Bossone, Eduardo

AU - Heiner, Susanne

AU - Knorr, Maike

AU - Jansen, Thomas

AU - Münzel, Thomas

AU - D’Ascenzo, Fabrizio

AU - Franke, Jennifer

AU - Sorici-Barb, Ioana

AU - Katus, Hugo A.

AU - Sarcon, Annahita

AU - Shinbane, Jerold

AU - Napp, L. Christian

AU - Bauersachs, Johann

AU - Jaguszewski, Milosz

AU - Shiomura, Reiko

AU - Nakamura, Shunichi

AU - Takano, Hitoshi

AU - Noutsias, Michel

AU - Burgdorf, Christof

AU - Ishibashi, Iwao

AU - Himi, Toshiharu

AU - Koenig, Wolfgang

AU - Schunkert, Heribert

AU - Thiele, Holger

AU - Kherad, Behrouz

AU - Tschöpe, Carsten

AU - Pieske, Burkert M.

AU - Rajan, Lawrence

AU - Michels, Guido

AU - Pfister, Roman

AU - Mizuno, Shingo

AU - Cuneo, Alessandro

AU - Jacobshagen, Claudius

AU - Hasenfuß, Gerd

AU - Karakas, Mahir

AU - Mochizuki, Hiroki

AU - Pott, Alexander

AU - Rottbauer, Wolfgang

AU - Said, Samir M.

AU - Braun-Dullaeus, Ruediger C.

AU - Banning, Adrian

AU - Isogai, Toshiaki

AU - Kimura, Akihisa

AU - Cuculi, Florim

AU - Kobza, Richard

AU - Fischer, Thomas A.

AU - Vasankari, Tuija

AU - Airaksinen, K. E.Juhani

AU - Tomita, Yasuhiro

AU - Budnik, Monika

AU - Opolski, Grzegorz

AU - Dworakowski, Rafal

AU - MacCarthy, Philip

AU - Kaiser, Christoph

AU - Osswald, Stefan

AU - Galiuto, Leonarda

AU - Crea, Filippo

AU - Dichtl, Wolfgang

AU - Murakami, Tsutomu

AU - Ikari, Yuji

AU - Empen, Klaus

AU - Beug, Daniel

AU - Felix, Stephan B.

AU - Delmas, Clément

AU - Lairez, Olivier

AU - Yamaguchi, Tetsuo

AU - El-Battrawy, Ibrahim

AU - Akin, Ibrahim

AU - Borggrefe, Martin

AU - Horowitz, John D.

AU - Kozel, Martin

AU - Tousek, Petr

AU - Widimský, Petr

AU - Gilyarova, Ekaterina

AU - Shilova, Alexandra

AU - Gilyarov, Mikhail

AU - Neuhaus, Michael

AU - Meyer, Philippe

AU - Arroja, Jose David

AU - Chan, Christina

AU - Bridgman, Paul

AU - Galuszka, Jan

AU - Poglajen, Gregor

AU - Carrilho-Ferreira, Pedro

AU - Pinto, Fausto J.

AU - Hauck, Christian

AU - Maier, Lars S.

AU - Liu, Kan

AU - Di Mario, Carlo

AU - Paolini, Carla

AU - Bilato, Claudio

AU - Bianco, Matteo

AU - Jörg, Lucas

AU - Rickli, Hans

AU - Winchester, David E.

AU - Ukena, Christian

AU - Böhm, Michael

AU - Bax, Jeroen J.

AU - Prasad, Abhiram

AU - Rihal, Charanjit S.

AU - Saito, Shigeru

AU - Kobayashi, Yoshio

AU - Lüscher, Thomas F.

AU - Ruschitzka, Frank

AU - Shimizu, Wataru

AU - Ghadri, Jelena R.

AU - Templin, Christian

PY - 2022/2

Y1 - 2022/2

N2 - Background: Ethnic disparities have been reported in cardiovascular disease. However, ethnic disparities in takotsubo syndrome (TTS) remain elusive. This study assessed differences in clinical characteristics between Japanese and European TTS patients and determined the impact of ethnicity on in-hospital outcomes. Methods: TTS patients in Japan were enrolled from 10 hospitals and TTS patients in Europe were enrolled from 32 hospitals participating in the International Takotsubo Registry. Clinical characteristics and in-hospital outcomes were compared between Japanese and European patients. Results: A total of 503 Japanese and 1670 European patients were included. Japanese patients were older (72.6 ± 11.4 years vs. 68.0 ± 12.0 years; p < 0.001) and more likely to be male (18.5 vs. 8.4%; p < 0.001) than European TTS patients. Physical triggering factors were more common (45.5 vs. 32.0%; p < 0.001), and emotional triggers less common (17.5 vs. 31.5%; p < 0.001), in Japanese patients than in European patients. Japanese patients were more likely to experience cardiogenic shock during the acute phase (15.5 vs. 9.0%; p < 0.001) and had a higher in-hospital mortality (8.2 vs. 3.2%; p < 0.001). However, ethnicity itself did not appear to have an impact on in-hospital mortality. Machine learning approach revealed that the presence of physical stressors was the most important prognostic factor in both Japanese and European TTS patients. Conclusion: Differences in clinical characteristics and in-hospital outcomes between Japanese and European TTS patients exist. Ethnicity does not impact the outcome in TTS patients. The worse in-hospital outcome in Japanese patients, is mainly driven by the higher prevalence of physical triggers. Trial Registration: URL: https://www.clinicaltrials.gov; Unique Identifier: NCT01947621.

AB - Background: Ethnic disparities have been reported in cardiovascular disease. However, ethnic disparities in takotsubo syndrome (TTS) remain elusive. This study assessed differences in clinical characteristics between Japanese and European TTS patients and determined the impact of ethnicity on in-hospital outcomes. Methods: TTS patients in Japan were enrolled from 10 hospitals and TTS patients in Europe were enrolled from 32 hospitals participating in the International Takotsubo Registry. Clinical characteristics and in-hospital outcomes were compared between Japanese and European patients. Results: A total of 503 Japanese and 1670 European patients were included. Japanese patients were older (72.6 ± 11.4 years vs. 68.0 ± 12.0 years; p < 0.001) and more likely to be male (18.5 vs. 8.4%; p < 0.001) than European TTS patients. Physical triggering factors were more common (45.5 vs. 32.0%; p < 0.001), and emotional triggers less common (17.5 vs. 31.5%; p < 0.001), in Japanese patients than in European patients. Japanese patients were more likely to experience cardiogenic shock during the acute phase (15.5 vs. 9.0%; p < 0.001) and had a higher in-hospital mortality (8.2 vs. 3.2%; p < 0.001). However, ethnicity itself did not appear to have an impact on in-hospital mortality. Machine learning approach revealed that the presence of physical stressors was the most important prognostic factor in both Japanese and European TTS patients. Conclusion: Differences in clinical characteristics and in-hospital outcomes between Japanese and European TTS patients exist. Ethnicity does not impact the outcome in TTS patients. The worse in-hospital outcome in Japanese patients, is mainly driven by the higher prevalence of physical triggers. Trial Registration: URL: https://www.clinicaltrials.gov; Unique Identifier: NCT01947621.

KW - Broken heart syndrome

KW - Ethnicity

KW - Race

KW - Takotsubo syndrome

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UR - http://www.scopus.com/inward/citedby.url?scp=85106242302&partnerID=8YFLogxK

U2 - 10.1007/s00392-021-01857-4

DO - 10.1007/s00392-021-01857-4

M3 - Article

C2 - 34013386

AN - SCOPUS:85106242302

SN - 1861-0684

VL - 111

SP - 186

EP - 196

JO - Clinical Research in Cardiology

JF - Clinical Research in Cardiology

IS - 2

ER -

Ethnic comparison in takotsubo syndrome: novel insights from the International Takotsubo Registry

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