%0 Journal Article
%T Differentiating Takotsubo cardiomyopathy from ST
%A Arsalan Abu-Much
%A Avi Sabbag
%A Dan Elian
%A Elad Asher
%A Israel Mazin
%A Qasim Odeh
%A Ronen Goldkorn
%A Roy Beigel
%A Sagit Ben Zekry
%A Shlomi Matetzky
%A Yael Peled
%A null
%J Hong Kong Journal of Emergency Medicine
%@ 2309-5407
%D 2019
%R 10.1177/1024907918795015
%X Takotsubo cardiomyopathy affects between 1.7% and 2.2% of patients hospitalized with suspected acute coronary syndromes. Characterized by chest pain, electrocardiogram changes, and transient left ventricular apical wall motion abnormality, it is under-recognized and often misdiagnosed. In order to better differentiate between St-segment myocardial infarction and Takotsubo cardiomyopathy, we developed a scoring system. Of the 82 patients enrolled with Takotsubo cardiomyopathy, 67 had ST-segment elevation on electrocardiogram and were compared with 79 ST-elevation myocardial infarction patients. A multi-variant logistic regression model was used to find factors independently associated with Takotsubo cardiomyopathy. The Platelets and Thrombosis in Sheba (PLATIS)-Takotsubo cardiomyopathy is based on a 10-point scoring system: stressful events (3), females (2), no history of diabetes mellitus (2), estimated left ventricular ejection fraction£¿¡Ü£¿40% on admission echo (1), positive troponin on admission (1), and no smoking (1). Patients with Takotsubo cardiomyopathy were older (66£¿¡À£¿11 vs 60£¿¡À£¿11£¿years, p£¿<£¿0.001), predominantly female (90% vs 15%, p£¿<£¿0.001), with a lower incidence of diabetes mellitus, dyslipidemia, and smoking. Nevertheless, in-hospital mortality was similar in both groups. In a multivariate logistic regression analysis, the average Platelets and Thrombosis in Sheba-Takotsubo cardiomyopathy scoring was significantly higher in Takotsubo cardiomyopathy compared with ST-elevation myocardial infarction patients (8.35£¿¡À£¿1.7 vs 3.42£¿¡À£¿1.6, p£¿<£¿0.001). With an overall score of£¿¡Ý7, the receiver-operating characteristic curve was 0.82 with a sensitivity of 75% and a specificity of 89% (positive predictive value£¿=£¿85% and negative predictive value£¿=£¿80%). The Takotsubo cardiomyopathy scoring system is a simple, reliable tool that can assist in diagnosing and differentiating between patients with Takotsubo cardiomyopathy and those with ST-elevation myocardial infarction
%K Takotsubo cardiomyopathy
%K ST-elevation myocardial infarction
%K diagnosis
%U https://journals.sagepub.com/doi/full/10.1177/1024907918795015