The pooled incidence of ischemic stroke in patients with Takotsubo cardiomyopathy was 4%, and ischemic stroke was associated with a significantly higher mortality risk (OR 7.57) compared to those without stroke.
Meta-Analysis (n=35,573)
Ischemic stroke occurs in approximately 4% of Takotsubo cardiomyopathy patients and is associated with a significantly increased risk of mortality.
Abstract Background Takotsubo cardiomyopathy (TC) is a cardiomyopathy characterized by temporary ventricular dysfunction, often resembling myocardial infarction. The association between ischemic stroke and TC remains unclear, with unknown true incidence. The objective of this study is to assess the incidence of ischemic stroke in TC patients and its risk factors. Methods We carried out a comprehensive search of PUBMED, Google Scholar, PROQUEST, and ScienceDirect databases from their inception to February 2026. Studies reporting the incidence of ischemic stroke in TC patients were included. The quality of studies was evaluated utilizing the Joanna Briggs Institute Critical Appraisal Tools. Statistical analyses were performed using Review Manager and RStudio. Results This study included six studies with 35,573 participants (841 had ischemic stroke and 34,732 did not). The pooled incidence of ischemic stroke was 4% (95% CI 0.01–0.06; I 2 = 91%). The incidence of all-cause mortality was 36% (95% I 0.02–0.71, I 2 = 81%) in TC patients with ischemic stroke, significantly higher than the 3.12% (95%CI:0.01–0.05, I 2 = 37%) observed in TC patients without stroke. The mortality risk was higher in TC patients with ischemic stroke (OR7.57; 95% CI 2.70–21.22). Age (MD: 3.04; 95% CI 0.74–5.34), sex (OR0.64; 95% CI 0.53–0.77), diabetes (OR1.73; 95% CI 1.00–3.00), and atrial fibrillation (OR1.87; 95% CI 1.28–2.72) were significantly related to the incidence of ischemic stroke. However, smoking and hypertension showed no significant association with ischemic stroke. Conclusions Ischemic stroke in TC patients correlates with an increased mortality rate and is associated with age, sex, and comorbidities, including diabetes and atrial fibrillation. Additional research is necessary to evaluate the possible advantages of anticoagulant therapy in TC patients.
Insanitaqwa et al. (Sun,) conducted a meta-analysis in Takotsubo cardiomyopathy (n=35,573). The pooled incidence of ischemic stroke in patients with Takotsubo cardiomyopathy was 4%, and ischemic stroke was associated with a significantly higher mortality risk (OR 7.57) compared to those without stroke.