Abstract
Background: Takotsubo syndrome (TTS) has been increasingly recognized in the United States. Since its initial description in 1990, diagnosed cases of TTS have been rising over time and the extent to which this trend differs by sex and across age is unclear. Methods: Using the National Inpatient Sample (NIS) data from 2006 to 2014, we identified hospitalizations with either a primary or secondary diagnosis of TTS. We analyzed these data stratified by sex and by age groups: <=50 years, 50 to 74 years, and >=75 years. For the trend measurements, the sampling effects were accounted for by applying NIS survey weights using the SAS PROC SURVEYMEANS procedure. Results: We identified a total of N=18,051 TTS cases over the study period, most of which were experienced by women (89.1%). The frequency of diagnosed TTS cases progressively increased from 2006 to 2014 in both women and men, across all age groups. However, the frequency of diagnosed TTS cases increased at a markedly more rapid rate in women compared to men (rate of change of 182.7 per million hospitalization per year in women vs 44.9 per million hospitalization per year in men, P<0.0001). The rate of increase in annual case diagnosis was particularly high for women aged 50 years or older compared to younger women or men of any age group ( Figure ). Conclusion: Our results demonstrate that while increasing recognition of TTS may be contributing to a steady rise of case diagnoses per annum in both sexes and across age groups, the rate of case diagnosis increase is particularly rapid in middle-aged and older women. Further research is needed to validate and investigate the potential determinants underlying our findings.
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