Abstract 14162: Impact of Migraine Headaches on Stress Induced Takotsubo Cardiomyopathy

Abstract

Introduction: Takotsubo cardiomyopathy (TTC) is an acute process, characterized by ventricular dysfunction, typically due to a neuro-cardiogenic mechanism. Although many stressors have previously been identified and can precipitate TTC, there have been no reports citing the association or effects of migraines attacks. Hypothesis: Migraines predispose a protective effect on TTC patients Methods: We conducted a US-wide analysis of TTC hospitalizations from 2013 to 2017 by querying the National Inpatient Sample database. Patients admitted with a principal diagnosis of TTC with a history of migraines were identified using the ICD-10 codes. TTC patients with migraines were then compared to TTC patients without migraines regarding mortality and acute inpatient complications (intubation, cardiac arrest, heart failure exacerbation, acute kidney injury). A logistic regression model was constructed to account for potential confounders. Results: A total of 172025 TTC patients were identified, of those patients, 3610 were found to have suffered from migraines. After accounting for potential confounders, TTC patients with a diagnosis of migraine were associated with a lower odds for mortality (OR: 0.388; [0.311-0.485]; p <0.001) and acute complications (OR: 0.511 [0.471-0.554]); p <0.001) compared to those without migraines. In terms of mortality, the presence of acute complications had the highest odds for mortality (7.830 [7.439-8.240]; p <0.001), followed by cerebrovascular disease, cancer, and age. Depression, Diabetes, smoking, and obesity were associated with a decreased odds for mortality. Conclusions: TTC patients with migraines were associated with lower mortality and better inpatient outcomes.