simple markers can distinguish takotsubo cardiomyopathy from st segment elevation myocardial infarction background takotsubo cardiomyopathy ttc is a clinical condition mimicking acute myocardial infarction a specific biomarker for ttc screening is required but until now no single biomarker has been established for the early diagnosis of ttc and differentiation from stsegment elevation myocardial infarction stemi in our study we focused on the simple markers that are available in every hospitalmethods in 66 consecutive patients pts who were hospitalized with ttc and 66 pts with stemi cardiac biomarkers such as ntprobnp tni ck and ckmb mass were determined during 12h from admission and compared with demographic clinical and echocardiographic findingsresults the concentration of ntprobnp was greater in pts with ttc than stemi 4702pgml vs 2138pgml the concentration of tni and ckmb mass was greater in the stemi group than in the ttc group tni 21ngml and ck mb mass 95ngml in pts with ttc vs tni 19ngml and ck mb mass 733ngml in pts with stemi the ntprobnptni ratio and ntprobnpckmb mass ratio were respectively 22352 and 6782 in pts with ttc and 816 and 275 in pts with stemi p0001 moreover the ntprobnpef ratio was also statistically significant 1104 in ttc group and 394 in stemi groupconclusions ntprobnptni ntprobnpckmb mass and ntprobnpef ratios can distinguish ttc from stemi at an early stadium the most accurate marker is the ntprobnptni ratio