Abstract 19119: Predictors and Outcomes of Myocardial Infarction in Patients With and Without Takotsubo Cardiomyopathy

Abstract

Introduction: Takotsubo Cardiomyopathy often presents as acute myocardial infarction (MI) due to reversible cardiac dysfunction caused by catecholaminergic surge. Hypothesis: Is there any difference in the short-term outcomes of the patients who present with MI accompanied with Takotsubo cardiomyopathy when compared to MI alone. Methods:: National Inpatient Sample Database of 2016-2019 was queried for the Primary ICD code of MI and secondary as Takotsubo Cardiomyopathy. The in-patient mortality was the primary outcome whereas CVA, CHF and Arrythmias were considered as secondary outcomes. Results: Around 3million patients were discharged with MI per year, out of which 4% had Takotsubo Cardiomyopathy (TC). 65% of the patients in both groups were older than 65 years. The mean age of patients for TC with MI was 68 years as compared to 70 years in the MI group without TC. The inpatient mortality for the patients with MI and TC was 28% whereas for those with MI alone was 18% (p=0.000) with the aOR 2.4 (95% CI1.97- 2.93 p=0.00). Female gender is not significantly associated with odds of TC in MI (aOR:1.077 p= 0.401 95% CI: .90-1.28). The percentage of TC with MI was more in Black population (18%) as compared to MI alone (13%) with p=0.007. No difference in the mean Charlson index was found between the two groups (4.5 vs 4.2). Patients with MI and TC had higher odds of atrial arrythmias (36% vs 31% p=0.001) with a OR: 1.35 p=0.001 (95% CI: 1.13-1.63). TC was associated with lesser odds of CVA, CAD, HTN, CHF and DM in MI where there was no difference in smoking, dyslipidemias and other baseline factors. Patients with TC had a higher mean LOS 0.5 days. Conclusions: Takotsubo cardiomyopathy is associated with higher odds of in-patient mortality, mean LOS and Atrial Arrythmias in MI without any difference in age, comorbidity index and gender.