Author + information
Takotsubo cardiomyopathy (TCM) is an increasingly reported transient non-ischemic regional systolic dysfunction of the left ventricle. We sought to examine temporal trends in incidence of TCM and identify clinical characteristics and predictors of in-hospital mortality.
The study population was derived from the HCUP-National Inpatient Sample for the years 2007-2013. ICD-9 CM codes were used to identify patients with TCM undergoing coronary angiography during the same admission. Baseline patient characteristics and in-hospital all-cause mortality were assessed. Multivariate analysis was used to adjust for baseline confounders.
Seventy-two thousand five hundred fifty-nine admissions with a diagnosis of TCM were identified during the study period. A significant increase in the incidence of TCM was observed from 11.1 cases per 100,000 hospitalizations in 2007 to 43.8 cases per 100,000 hospitalizations in 2013 (p<0.001). One thousand eight hundred twenty-five (2.5%) patients died prior to hospital discharge. Expired patients were more likely to be older (69.2 vs. 66.4, p<0.0001), diabetic, with a higher baseline clinical risk. After multivariate adjustment, independent predictors of mortality included age, female gender, alcohol disorders, hypertension, acute kidney injury, multiple myeloma, chronic obstructive pulmonary disease, peripheral vascular disease, pulmonary hypertension, arrhythmias, peri-endo-myocarditis and hepatitis. (Table 1)
Hospital admissions for TCM have significantly increased in the U.S. during the last six years. In-hospital mortality is infrequent in patients hospitalized with TCM. Nevertheless, multiple modifiable and non-modifiable factors are associated with a significant increase in mortality.