Cardiac biomarkers for diagnosing Takotsubo syndrome

In this study, involving patients from the world’s largest cohort of TTS patients, the efficacy of biomarker ratios in distinguishing TTS from ACS was found to be only moderately successful, with AUC values ranging from 0.5 to 0.8. Despite previous claims that these ratios could accurately differentiate between TTS and ACS, the originally anticipated excellent diagnostic accuracies could not be replicated in our international cohort of TTS patients. Although peak value ratios offer better distinction, the application of peak values in diagnostic ratios for cases with elevated ST-segments poses challenges, as immediate treatment is mandatory. Moreover, the integration of clinical variables and biomarkers holds significant promise for differentiating between the two entities with a higher level of diagnostic accuracy. The variability in the timing of blood collection across different centres for assessment of peak values should be acknowledged as a limitation of a large registry investigating a condition with low incidence, such as the InterTAK. However, measurement of admission values was performed according to international guidelines for the management of ACS.