New Blood Test Tells "Broken Heart Syndrome" Apart From a Real Heart Attack

Takotsubo syndrome, sometimes called "broken heart syndrome," is a sudden heart condition that most often affects postmenopausal women and can be triggered by intense emotional or physical stress. It accounts for about 2% of patients initially thought to be having a heart attack, and up to one in ten women with acute coronary syndrome. The two conditions look nearly identical at first — both cause chest pain, abnormal ECG results and elevated cardiac enzymes — but Takotsubo does not involve blocked coronary arteries, so many patients undergo invasive cardiac catheterization before doctors find the real cause.

An international team working with the universities of Zurich and Greifswald has developed and validated a diagnostic scoring system, called the BioTAK score, to identify Takotsubo syndrome before catheterization. It combines biological sex with several blood biomarkers, selected using artificial intelligence for their diagnostic value. In an independent validation group of nearly 1,800 additional patients, the score correctly classified nearly 90% of participants before catheterization. "A simple combination of blood biomarkers and biological sex can identify these patients with remarkable accuracy even before cardiac catheterization," said Florian A. Wenzl, co-first author at the University of Zurich's Center for Molecular Cardiology and the University of Oxford.

Two of the biomarkers point to a role for the brain-heart axis, suggesting Takotsubo develops through mechanisms separate from atherosclerosis, the buildup of plaque in arteries. One protein helps activate neuropeptides involved in stress responses and autonomic nervous system activity; the other is linked to the stability of atherosclerotic plaques. "The BioTAK score translates complex disease mechanisms into a practical diagnostic tool," said co-last author Thomas Lüscher of Imperial College London's National Heart and Lung Institute.

"The BioTAK score is not a substitute for cardiac catheterization when medically necessary, but it could help guide diagnostic procedures and avoid unnecessary invasive tests in selected patients," said co-last author Christian Templin of University Medical Center Greifswald, founder of the InterTAK Registry. Published in the European Heart Journal, the study drew on Switzerland's SPUM-ACS Registry and the International Takotsubo (InterTAK) Registry, established in 2010, analyzing data from more than 3,600 patients with acute coronary syndrome or Takotsubo syndrome.