Abstract 11513: Impact of Family History of Coronary Artery Disease on Clinical Outcomes in Takotsubo Cardiomyopathy

Abstract

Introduction: Family history of coronary artery disease (CAD) is a critical risk factor for CAD, underscoring the contribution of genetic factors to disease pathogenesis and susceptibility. Takotsubo cardiomyopathy (TCM) simulates the clinical features of and frequently coexists with CAD. However, the association between family history of CAD (FHxCAD) and TCM is unclear. Aim: We examined the impact of FHxCAD on in-hospital clinical outcomes of TCM patients. Methods: This retrospective cohort study was conducted using the National Inpatient Sample database [2016-2018]. We identified 4,733 patients admitted to hospital with a primary diagnosis of TCM (ICD-10 coding system); 648 (13.7%) had a FHxCAD. We performed propensity score matching at 1:1 ratio (n=646, matched TCM with FHxCAD; n=646, matched TCM without FHxCAD), and we compared in-hospital outcomes and complications between TCM patients with or without a FHxCAD. Results: In the unmatched cohort, the TCM with FHxCAD group had a reduced incidence of cardiogenic shock, acute kidney injury (AKI) and acute respiratory failure (ARF); lower mortality rates; shorter length of stay (LOS); and decreased total charge compared to the TCM without FHxCAD group (p<0.05). After propensity score matching, the TCM with FHxCAD group, when compared with the TCM without FHxCAD group, also had a lower incidence of cardiogenic shock (2.2% vs. 6.3%, p<0.001; odds ratio [OR] 0.33, 95% confidence interval [CI], 0.18-0.61), AKI (5.1% vs. 8.7%, p=0.016; OR 0.57, 95% CI, 0.36-0.88), and ARF (5.7% vs. 12.7%, p<0.001; OR 0.42, 95% CI, 0.28-0.63); decreased in-hospital mortality (<11 vs. 3.1%, p=0.002; OR 0.2, 95% CI, 0.07-0.57); shorter LOS (2.66 ± 1.96 days vs. 3.40 ± 3.05 days, p<0.001); and a reduced total charge (p=0.001), respectively. The incidence of cardiac arrest and ventricular arrhythmias did not differ significantly based on FHxCAD in the unmatched or matched cohorts. Conclusions: Family history of CAD was associated with favorable clinical outcomes in both unmatched and propensity-matched cohorts of in-hospital TCM patients. Further studies are necessary to identify mechanisms contributing to the association between in-hospital TCM outcomes and FHxCAD.