Abstract 13332: Obesity Paradox in Stress Cardiomyopathy When Comparing Outcomes

Abstract

Introduction:Stress Cardiomyopathy (SCM), is an acute reversible myocardial injury associated with transient left ventricular dysfunction. Risk factors include female sex, post-menopause, anxiety, depression, schizophrenia, asthma and chronic obstructive pulmonary disease, diabetes, and substance use. Obesity has an increased sympathetic tone and state of chronic metabolic stress, both of which are similar in etiology to SCM. We postulate that obesity may have high prevalence in patients with SCM. Methods: We queried the Nationwide Inpatient Sample database (2016-2019) to identify adult patients with SCM with and without obesity, along with other common co-morbidities using ICD-10 codes. We compared the categorical and continuous variables by Pearson χ2 and Student t test. Results: There were 31,725 patients with SCM. The mean age was 67.15 + 14 years and the population was predominately female, n=26409 (83.2%). Racial distribution consisted of White (n=24713 77.9%), Black (n=24713, 8%), and Hispanic (n=1918, 6%). There were 3816 (12%) who were diagnosed with obesity. When comparing both groups, obese patients were found to be younger than non-obese, 63.3 + 14 years vs. 67.68 + 13 years, p<0.001, respectively. Obese patients had higher incidences of hypertension (n=10317; 38.9% vs. 1485; 37%, p=0.005), chronic kidney disease (n=3874; 17.5% vs. n=668; 13.9%, p<0.001), dyslipidemia (n=1771; 46.4% vs. n=10625; 38.1%, p <0.001), diabetes mellitus (n=373; 9.8% vs n=1278; 4.6%, p<0.001), non-alcoholic fatty liver disease (n=30; 0.8% vs. n=68; 0.2%, p<0.001), and polycystic ovarian syndrome (n= 30; 0.8% vs n=68; 0.2%, p<0.001). Tobacco use was higher in non-obese vs. obese patients (n=311; 1.1% vs. 28; 0.7%, p=0.32). The length of stay for both groups was similar, 7-days. Obese patients had a lower total hospital charges ($95,098 vs. $98,735). There was a lower incidence of mortality among obese patients n=194 (5.1%) vs. non-obese n=1743 (6.2%), p<0.005. Conclusion: Despite obese patients having more risk factors for developing SCM than non-obese patients, they were found to have decreased mortality and a lower cost of stay. These findings suggest that obesity may play a paradoxical role in SCM.