Diabetes mellitus prevalence in patients with takotsubo syndrome: the case of the brain-heart disconnect

Background: Hyperactive autonomic nervous system (ANS) is among the postulated pathophysiologic mechanisms of takotsubo syndrome (TTS). Diabetes mellitus (DM) with its associated ANS peripheral neuropathy could exert a “protective” influence for the emergence of TTS. Methods: A patient-based meta-analysis of the data obtained from all patients presented individually was carried out, focusing on age, gender, and history of hypertension (HTN) and DM. Results: The prevalences of HTN and DM for all 2,342 patients, aged 61.1 ± 17.3, 85.1% female, were 37.4% and 9.5%, for patients ≥ 60 years old were 45.8% and 11.7%, and for patients ≥65 years old were 48.2% and 12.3%, correspondingly. The prevalence of DM in patients with TTS is less than half of the world's and USA's elderly populations. Conclusions: Prevalence of DM in patients with TTS is lower than in the general population, suggesting that DM, may have a “protective” effect for the emergence of TTS.