Coronary disease & ACSMeta-analysis

Diagnostic Models to Differentiate Takotsubo Syndrome from Acute Coronary Syndrome: A Systematic Review and Meta-Analysis

Eur J Heart FailPublished

  • Systematic review and meta-analysis of diagnostic prediction model studies
  • random-effects meta-analysis
  • PROBAST risk-of-bias assessment
  • narrative synthesis

Search of PubMed, EMBASE and Scopus until January 2024; 1015 articles screened

Authors' conclusion

Our review identified multiple diagnostic models to diagnose Takotsubo syndrome. Although most models showed acceptable-to-good discriminative performance, calibration measures were almost unreported and the risk of bias was a concern in most studies.

Study context

Population
Patients with Takotsubo syndrome or acute coronary syndrome (ACS); observational studies developing and/or validating multivariable diagnostic models
Participants
4,552 patients · 11 studies
Comparison
Multivariable diagnostic models to differentiate Takotsubo syndrome from ACS
  • InterTAKn = 4
Outcome
Diagnostic performance of models (c-statistic, calibration) distinguishing Takotsubo syndrome from ACS

Pooled result

As reported in the abstract

Discrimination (c-statistic)
GroupSummary c-statisticStudies
InterTAK0.89 (95% CI 0.73-0.96)4
Reported c-statistic range across all models
0.77 to 0.97
New diagnostic models identified
8
External validations of existing models
8
Models with calibration plots reported
2

Further pooled results

Risk of bias and applicability (PROBAST)

Applicability of low concern
50%
Applicability of unclear concern
50%
Risk of bias high for all models

Original publication

Diagnostic Models to Differentiate Takotsubo Syndrome from Acute Coronary Syndrome: A Systematic Review and Meta-Analysis. Eur J Heart Fail. Published 14 January 2025. doi:10.1002/ejhf.3584

Summarised from the published abstract; every number is checked against it