Abstract 14873: Analysis of Heart Failure Re-Admissions and In-Hospital Outcomes in Patients With Takotsubo Syndrome

Abstract

Background: Takotsubo Syndrome (TTS) is characterized by transient reduction in left ventricular function with in the absence of obstructive coronary artery disease. Clinical presentation often mimics acute myocardial infarction (AMI). Patients with TTS have comparable long-term mortality with AMI patients. However, data on the burden of heart failure (HF) readmissions in patients with TTS are scarce. Methods: This retrospective analysis utilized the US Nationwide Readmission Database for the years 2012-2019 to identify hospitalizations for TTS or AMI. The primary outcome of interest was 6-month readmission due to HF. Secondary outcomes included in-hospital mortality. Results: There were 30,926 hospitalizations with TTS and 2,535,025 hospitalizations with AMI. The proportion of women was 90% among TTS patients and 37.7% among AMI patients (p<0.001). Overall comorbidities were similar between the two groups, but in-hospital mortality during index admission was higher in the AMI arm (6.5% vs 1.5% in TTS, p <0.01) accompanied with increased in-hospital complications. All-cause readmission rates were lower among TTS than among AMI patients (21.9% vs. 29.4%; p <0.01). HF readmissions were also lower among TTS than AMI patients (3.7% vs. 6.7%; p <0.01). After propensity matching, all-cause readmission rate remained lower among TTS than among AMI patients (21.9% vs. 27.9%; p <0.01). HF hospital readmissions rates were also lower among TTS patients (3.7% vs 5.7%; p <0.01). Independent predictors of HF readmission in TTS population included comorbidities such as diabetes mellitus, atrial fibrillation, chronic kidney disease, peripheral vascular disease, and chronic pulmonary disease. Conclusion A substantial proportion of patients (>20%) with TTS suffer a hospital readmission within 6 months, although less than 5% are readmitted with HF. Compared with AMI, all-cause and HF readmission rates are lower in TTS patients.