We thank Madias for his positive comments on our article. Regarding the statistical aspects, we agree that performing propensity score matching1 or posthoc sensitivity analyses2,3 could have helped to gain a better understanding of the effect of the antiplatelet therapy on the prognosis of patients with Takotsubo syndrome.

With regard to the presence of diabetes and obesity in the Spanish population, data from the 2021 IDF Diabetes Atlas and the Spanish Statistics Office show a prevalence of 14.8% for diabetes and a prevalence of 16.0% for obesity in the overall Spanish population.4,5 These data could exceed 25% in women >70 years.6 Although the presence of diabetes and obesity could be underrepresented in our population, it is not plausible that the presence of either of these two diseases could have caused bias in any direction in the results, because the parameters for diabetes and obesity are well balanced between the comparison groups (diabetes in the APT at discharge group: 16.5% vs. diabetes in no APT at discharge group: 15.6%, p=0.791; obesity in APT at discharge group: 17% vs. obesity in non-APT at discharge group: 15.7%, p=0.701).