In Takotsubo Syndrome, high neutrophil-to-lymphocyte ratio predicted worse survival, while elevated lymphocyte-to-monocyte ratio was linked to better prognosis.
Do admission inflammatory markers, specifically neutrophil-to-lymphocyte ratio (NLR) and lymphocyte-to-monocyte ratio (LMR), predict mortality and in-hospital complications in patients with Takotsubo Syndrome?
Elevated neutrophil-to-lymphocyte ratio (NLR) predicts worse survival and in-hospital complications, while elevated lymphocyte-to-monocyte ratio (LMR) predicts better prognosis in patients with Takotsubo Syndrome.
Abstract Background Takotsubo Syndrome (TTS) is a transient cardiac dysfunction that mimics acute coronary syndrome (ACS) but occurs without coronary obstruction. Emerging evidence suggests that systemic inflammation plays a role in TTS pathophysiology, yet its prognostic significance remains unclear. This study investigates the role of inflammatory markers in TTS patients from the German Italian Spanish Takotsubo (GEIST) Registry. Methods We analyzed 280 TTS patients and 280 age- and sex-matched ACS patients. Leukocyte parameters, including neutrophil-to-lymphocyte ratio (NLR) and lymphocyte-to-monocyte ratio (LMR), were assessed on admission. The primary endpoint was all-cause mortality, the secondary endpoint was in-hospital complications. Results Monocyte levels were significantly higher in TTS than in ACS (0.63±0.3 vs 0.51±0.24, p0.001). Independent predictors of in-hospital complications included physical triggers, left ventricular ejection fraction (LVEF), and NLR. Age, physical triggers, LVEF, NLR, and LMR were associated with long-term mortality. High NLR predicted worse survival, while elevated LMR was linked to better prognosis. Conclusions This study confirms the prognostic value of NLR in TTS and, for the first time, highlights LMR as a potential prognostic marker. These findings support the role of inflammation in TTS and suggest it might be a potential therapeutic target. Further prospective studies are warranted to clarify the inflammatory mechanisms underlying TTS and their clinical implications
Novo et al. (2025) studied this question. In Takotsubo Syndrome, high neutrophil-to-lymphocyte ratio predicted worse survival, while elevated lymphocyte-to-monocyte ratio was linked to better prognosis.