Abstract 9753: Outcomes of Substance Abuse Among Patients With Takotsubo Cardiomyopathy

Abstract

Introduction: Takotsubo cardiomyopathy (TC) is a reversible cardiomyopathy that is precipitated by emotional or physical stress mediated by catecholamines. Drugs that modulate adrenergic tone can precipitate/ worsen TC Hypothesis: To compare the prevalence of comorbidities and incidence of complications in TC patients with substance abuse (SA) compared to those without SA Methods: The United States NIS data from 2016 to 2018 was queried to identify adult patients (≥18 years) with TC using ICD 10 code. SA was defined as use of opiates or cannabis or cocaine. Chi- square test was applied for statistical analysis Results: We identified a total of 23, 220 patients with TC. 5.3% had history of SA. The prevalence of opioid, cannabis and cocaine use was 2.4 %, 2% and 1% respectively. Comparing the two groups (SA vs no SA), mean age was 56.8y vs 67.3y. the prevalence of hypertension (56% vs 67%; p<0.001), diabetes (15% vs 19%; p=0.007), and obesity (11 % vs 13%; p=0.04) atrial fibrillation (7 % vs 13.6%; p<0.001) coronary artery disease (50% vs 54%; p= 0.02) were lower. The prevalence of any psychiatric disorder (60.6% vs 38.2%; p<0.001), heart failure (36% vs 31%; p <0.001), chronic obstructive pulmonary disease (36% vs 28.5%; p <0.001), tobacco use (71% vs 42%; p<0.001) and alcohol use(11.4% vs 4%; p <0.001) were higher. Outcomes were (SA vs no SA)- cardiogenic shock (2.4% vs 3%; p =0.31), mechanical ventilation (9% vs 4.5%; p< 0.001), acute kidney injury (3% vs 8.4%; p <0.001), cardiac arrest (2.8% vs 1.5%; p <0.001), mitral regurgitation (4.5% vs 6.4%; p =0.007), ventricular tachycardia (5.7% vs 3.3%;p< 0.001) ventricular fibrillation (2% vs 1%;p <0.001) Conclusions: TC patients with SA had a lower cardiovascular risk factors such as hypertension, type 2 diabetes, obesity, high burden of psychiatric disorders, high rates of in hospital complications like need for mechanical ventilation, cardiac arrest and ventricular arrhythmias but no difference in the rates of cardiogenic shock compared to no SA group. Prospective studies are needed to confirm the impact of SA disorder on incidence and outcomes of TC in this cohort