Abstract P050: A QUERY OF THE DIABETES PARADOX IN TAKOTSUBO CARDIOMYOPATHY

Abstract

Background: Observational studies have demonstrated a low prevalence of diabetes mellitus (DM) in patients with takotsubo cardiomyopathy (TCM) and also suggested a possible protective role due to underlying autonomic neuropathy. its impact on TCM outcomes is unclear. Methods: We recruited 8081 patients from 2011, 2012 National Inpatient Sample, 6325 had TCM while 1756 had TCM with DM. Our outcomes of interest were overall mortality, mechanical hemodynamic support (MHS), acute respiratory failure(ARF), cardiac arrest (SCA), cardiogenic shock (CS), and stroke. Logistic regression was used to estimate the adjusted odds ratio of the outcomes in the study compared to the control group while stratified analysis was used to adjust for sex both accounting for underlying comorbidities. Results: The mean age was 60.4 years. There was no difference in overall mortality (4.1% vs 3.5%; P =0.154), cardiogenic shock (6.2% vs 6.2%; P=0.905), atrial fibrillation (11.1 vs 11.8; P= 0.224), stroke (1.9% vs 2.3%; P= 0.139) and MHS (2.3% vs 2.8%; P= 0.086). The rate of acute respiratory failure was significantly higher in DM+TCM patients compared to TCM alone (20.8% vs 18.2%; P= 0.021). Table 1 reveals the adjusted odds ratio for outcomes while table 2 stratified analysis based on age and sex. Patients with TCM+ DM have higher odds for acute respiratory failure and the use of MHS. The stratified analysis revealed that compared to TCM alone, females with TCM +DM are more likely to develop acute respiratory failure, stroke, and the use of MHS, while male patients were more likely to develop atrial fibrillation. Conclusion: Underlying DM is associated with an increased risk for poor outcomes in patients with TCM.