ArticleJACC. Asia2026
Non-ACS Presentation in Takotsubo Syndrome: A High-Risk Phenotype with Distinct Treatment Patterns and Worse Outcomes.
Article in JACC. Asia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- The 2 Faces of Takotsubo Syndrome: Why the Initial Presentation Defines the Clinical Trajectory.JACC. Asia · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
18 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTakotsubo syndrome (TTS) is frequently misdiagnosed as acute coronary syndrome (ACS), yet a substantial proportion of patients present without typical ACS features-often leading to delayed recognition and suboptimal management. The prognostic implications of the non-ACS phenotype remain poorly characterized, particularly in Asian populations.
objectivesThis study aimed to investigate the treatment patterns and outcomes of non-ACS TTS.
methodsUsing data from the multicenter TAKOC (Takotsubo syndrome of Chinese patients) Registry (18 tertiary hospitals in China), we compared 421 TTS patients stratified by initial presentation: ACS-like (typical chest pain, ischemic electrocardiogram changes, and peak troponin >10-fold the upper limit of normal) versus non-ACS. Inverse probability of treatment weighting was applied to account for baseline imbalances.
resultsNon-ACS TTS (n = 257, 61.0%) was associated with male sex, physical triggers, dyspnea as primary symptom, lower left ventricular ejection fraction, and higher incidence of cardiogenic shock. Paradoxically, despite significantly lower troponin levels, these patients experienced markedly higher 30-day all-cause mortality (adjusted HR: 2.28; 95% CI: 1.18-4.41; P = 0.017) and long-term mortality (adjusted HR: 2.44; 95% CI: 1.32-4.51; P = 0.043). Patients in the non-ACS group required more intensive in-hospital support-including diuretics, vasoactive drugs, and mechanical circulatory support; however, they received fewer cardiovascular medications (antiplatelets, beta-blockers, and renin-angiotensin-aldosterone system inhibitors) that were independently associated with lower 30-day mortality.
conclusionsNon-ACS presentation defines a high-risk TTS subtype characterized by atypical symptoms and disproportionately poor outcomes-despite less pronounced biomarker elevation. These findings underscore the critical need for heightened clinical suspicion and exploring effective treatment strategies for patients with TTS. (Registration number: ChiCTR2300075095).
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.