BioTAK flags broken-heart syndrome before catheterization

Chest pain, an altered electrocardiogram and elevated cardiac enzymes send a clear signal: treat the patient as a possible heart attack. Yet Takotsubo syndrome—often called broken-heart syndrome—can produce the same emergency profile while leaving the coronary arteries unblocked. Most patients therefore undergo invasive cardiac catheterization before doctors can tell the two conditions apart.

An international team working with researchers from the universities of Zurich and Greifswald has developed BioTAK, a diagnostic score designed to identify Takotsubo syndrome earlier. It combines biological sex with several blood biomarkers, selected using artificial intelligence to find the most informative pattern. In an independent validation study involving nearly 1,800 additional patients, predefined thresholds correctly classified nearly 90% of participants before catheterization.

The score does more than sort patients. Two of its biomarkers point to the brain-heart axis—the biological links between stress responses and heart function—and to a mechanism independent of atherosclerosis, the buildup of plaques in the arteries. One protein is involved in activating neuropeptides that regulate stress responses, anxiety, blood-vessel tone and the autonomic nervous system; the other is associated with the stability of atherosclerotic plaques.

That difference matters because Takotsubo syndrome primarily affects postmenopausal women and is often triggered by severe emotional or physical stress, while appearing in about 2% of all patients with suspected heart attacks and as many as one in 10 women with acute coronary syndrome. BioTAK turns those biological signals into a practical aid for the first emergency assessment, rather than treating every similar presentation as the same disease.

And then? In selected patients, the score could help clinicians decide more efficiently who needs an invasive test and who may avoid an unnecessary catheterization. It cannot replace catheterization when the procedure is medically necessary. The published validation supports the tool’s potential, but future studies still need to determine whether adding BioTAK to routine clinical practice improves diagnosis and treatment.