Abstract 17115: Age-Related Outcomes for Takotsubo Syndrome Differ by Sex

Abstract

Background: Takotsubo syndrome (TTS) is an uncommon but increasingly recognized cause of myocardial infarction in both women and men across the age spectrum. Emerging data suggest that outcomes are worse in younger compared to older adults, and the extent to which this trend differs by sex is unclear. Methods: Using the National Inpatient Sample data from years 2006 to 2014, we identified hospitalizations with either a primary or secondary diagnosis of TTS. We analyzed these data stratified by age and sex. Outcomes measured include in-hospital mortality and in-hospital complications of cardiac arrest, cardiogenic shock, any type of shock, vasopressor use, intra-aortic balloon pump use, and mechanical ventilation. Results: We identified a total of N=18,051 TTS cases over the study period, most of which were experienced by women (89%). Despite the majority cases occurring in patients over age 50 years (89%), younger patients hospitalized with TTS were consistently more likely to suffer almost all major types of in-hospital complications except for in-hospital mortality ( Figure ). These apparently paradoxical age-based trends were observed in women more so than in men. Conclusion: Our results demonstrate that while individuals age 50 years and older continue to be more frequently hospitalized with TTS than younger patients, younger patients present with greater complications. This age-based finding is seen predominantly in women and much less so in men, potentially related to sex differences in sympathetic regulation of cardiovascular responses to stress. Further research is needed to validate and investigate the potential mechanisms underlying our findings.