Predictors of Mortality in Patients with Takotsubo Cardiomyopathy (Insights from the National Inpatient Sample)

Abstract

Background Takotsubo cardiomyopathy (TTC), also known as stress cardiomyopathy, is an acute and typically reversible heart failure syndrome classically characterized by apical akinesis following an acute emotional or physiologic stressor. Although it had been first thought to be a benign condition, it has gained increasing recognition as a syndrome associated with poor clinical outcomes and death. The aim of this study is to identify the predictors of mortality in patients with TTC. Methods This is a retrospective study using the National Inpatient Sample (NIS) of patients hospitalized with TTC (ICD9 code 429.83) between 2012 and 2016 (n=32,500). All patient demographics were obtained and the primary outcome was in-hospital mortality. Chi-squared tests and multivariate regression were used for statistical analysis. Results Overall, TTC was more prevalent in women (85%) and mean age was 67.2 (±13.9) years. Out of the 32,500 identified patients, 81.7% were White, 7.6% were Black, and 5.9% were Hispanic. The inpatient mortality rate was 5.4% with a mean length of stay of 6.7 (±8.9) days. Compared to patients with TTC who survived to discharge, patients with TTC who died during the hospitalization were more likely to be older (68.8 vs. 67.2, p-value Conclusion TTC is a syndrome associated with an in-hospital mortality rate of 5.4%. Furthermore, patients with TTC that are more likely to die during the index hospitalization are older, males, and non-whites. Preexisting conditions, such as cerebral vascular accidents and atrial arrhythmias were associated with increased mortality in this population.