Abstract 50: Atrial Fibrillation is Associated with Higher Stroke Rates in Takotsubo Cardiomyopathy

Abstract

Background: The prognosis of Takotsubo Cardiomyopathy (TTCM) is worse than in the general population. It is unclear how atrial fibrillation (AF) impacts this prognosis. We sought to evaluate the effect of concurrent AF on outcomes in patients with TTCM. Methods: We used the Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS) to extract all hospitalizations between 2007 and 2011 with concurrent diagnosis of AF and TTCM. The ICD-9 CM codes for AF and TTCM were used. We compared patients admitted for TTCM who had coexisting AF to those without. We excluded patients below the age of 18 as well as those diagnosed with TTCM who later underwent percutaneous coronary intervention (PCI). Multivariate regression was used to assess the independent effect of coexisting AF on clinical outcomes (length of stay (LOS), stroke, and in-hospital mortality). Results: A total of 13,136 TTCM patients were studied. Of these, 2,083 (15.86%) had coexisting AF. Compared with those without, TTCM patients with coexisting AF had a greater multivariate-adjusted risk for increased stroke rate (aOR=1.66, 95% CI=1.27-2.18, Table 1). We found no significant association with in-hospital mortality (aOR=1.21, 95% CI=0.96-1.52) or LOS (aOR=1.21, 95% CI= 0.83-1.58). Conclusions: In this large, nationally representative study, we found higher stroke rates in patients with coexisting AF and TTCM. Our findings suggest the need for closer monitoring during hospitalization.