• Jelena R Ghadri, Victoria L Cammann, Stjepan Jurisic, Burkhardt Seifert, L Christian Napp, Johanna Diekmann, Dana Roxana Bataiosu, Fabrizio D'Ascenzo, Katharina J Ding, Annahita Sarcon, Elycia Kazemian, Tanja Birri, Frank Ruschitzka, Thomas F Lüscher, Christian Templin, and InterTAK co-investigators.
• University Heart Center, Department of Cardiology, University Hospital Zurich, Zurich, Switzerland.
• Eur. J. Heart Fail. 2017 Aug 1; 19 (8): 1036-1042.

AimsClinical presentation of takotsubo syndrome (TTS) mimics acute coronary syndrome (ACS) and does not allow differentiation. We aimed to develop a clinical score to estimate the probability of TTS and to distinguish TTS from ACS in the acute stage.Methods And ResultsPatients with TTS were recruited from the International Takotsubo Registry ( www.takotsubo-registry.com) and ACS patients from the leading hospital in Zurich. A multiple logistic regression for the presence of TTS was performed in a derivation cohort (TTS, n = 218; ACS, n = 436). The best model was selected and formed a score (InterTAK Diagnostic Score) with seven variables, and each was assigned a score value: female sex 25, emotional trigger 24, physical trigger 13, absence of ST-segment depression (except in lead aVR) 12, psychiatric disorders 11, neurologic disorders 9, and QTc prolongation 6 points. The area under the curve (AUC) for the resulting score was 0.971 [95% confidence interval (CI) 0.96-0.98] and using a cut-off value of 40 score points, sensitivity was 89% and specificity 91%. When patients with a score of ≥50 were diagnosed as TTS, nearly 95% of TTS patients were correctly diagnosed. When patients with a score ≤31 were diagnosed as ACS, ∼95% of ACS patients were diagnosed correctly. The score was subsequently validated in an independent validation cohort (TTS, n = 173; ACS, n = 226), resulting in a score AUC of 0.901 (95% CI 0.87-0.93).ConclusionThe InterTAK Diagnostic Score estimates the probability of the presence of TTS and is able to distinguish TTS from ACS with a high sensitivity and specificity.Trial RegistrationNCT0194762.© 2016 The Authors. European Journal of Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.

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