Impact of Migraine Headaches on Stress-Induced ‘Takotsubo’ Cardiomyopathy

Abstract

IntroductionTakotsubo cardiomyopathy (TCM) is an acute left ventricular dysfunction, typically due to a neuro-cardiogenic mechanism. Although many stressors can precipitate TCM, the role of migraines in hospitalized TCM patients has not been studied. Our objective is to describe the in-hospital outcomes of TCM in patients with a concurrent diagnosis of migraines. MethodsWe conducted a US-wide analysis of TCM hospitalizations from 2013 to 2017 by querying the National Inpatient Sample database for the International Classification of Diseases, Ninth and 10th Revisions (ICD-9 and ICD-10). Patients admitted with a principal diagnosis of TCM with a history of migraines were identified using the ICD-10 codes. TCM patients with migraines were then compared to TCM patients without migraines regarding mortality and acute inpatient complications (intubation, cardiac arrest, heart failure exacerbation, acute kidney injury). A logistic regression model was constructed to account for potential confounders. ResultsA total of 172,025 TCM patients were identified. Of those patients, 3610 suffered from migraines.TCM patients with a diagnosis of migraine were associated with a lower odds for mortality (OR: 0.388; [0.311–0.485]; p < 0.001) and acute complications (OR: 0.511 [0.471–0.554]; p < 0.001) compared to those without migraines. After adjusting for confounders, the adjusted odds ratio for mortality was 0.622; [0.495–0.782]; p < 0.001, and acute complications were 0.563 [0.519–0.611]; p < 0.001. ConclusionsTCM patients with migraines were found to have a better outcome and mortality. They had significantly fewer complications (cardiac arrest, heart failure exacerbation, intubation, acute kidney injury).