Background: Mortality in male patients with Takotsubo cardiomyopathy appears to be double than the mortality rate of Women. The goal of this study was to evaluate whether the higher mortality is related to a higher complication rate in male adults Methods: Using ICD-10 codes for Takotsubo cardiomyopathy, we evaluated differences in the occurrence of complications between Men and women. Results: A total of 199,890 patients had a diagnosis of Takotsubo cardiomyopathy, with 4,770 male and 165,120 female patients. All major complications are significantly higher in men than women, despite multivariate adjustment for age and cardiovascular risk factors. Cardiogenic Shock: 9.88% vs 5.98% p<0.001, OR: 1.57, 1.43-1.73, Atrial Fibrillation: 23.96% vs 20.12%, p<0.001, OR:1.55, CI 1.45-1.66, Cardiac Arrest: 5.71% vs 2.94%, p<0.001, OR: 1.71, CI 1.51-1.94, Congestive Heart Failure: 39.52% vs 35.18% p <0.001, OR: 1.23, CI:1.16-1.30, Stroke: 7.45% vs 4.94%, p<0.001, OR: 1.51, CI:1.36-1.68). Conclusions: All major cardiovascular complications are higher in men compared to women with a diagnosis of Takotsubo cardiomyopathy, as a plausible explanation for the higher mortality in men.

The authors have declared no competing interest.

none

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

This data base is publicilay available without a patients identifier exempt from IRB

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

NIS data is publicialy available