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Takotsubo cardiomyopathy (TCM) is an increasingly recognized condition that often mimics myocardial infarction (MI). Distinction is important because the clinical course differs extensively, as TCM has favorable prognosis with full LV recovery. Although first reported in Japan, limited information is available on differences by ethnicity on the prevalence of TCM. Using the MI population as the control of ethnic diversity, we aimed to examine the ethnic variation of TCM at our institution.
We retrospectively reviewed 67 cases of TCM diagnosed between October 2004 and October 2015. Consecutive patients with MI during 2013 and 2014 were identified from our cardiac catheterization database. The ethnic diversity for both TCM and MI was compared and analyzed for statistical difference using Fisher’s exact test.
Overall incidence of TCM in patients initially suspected as MI was 1.6% per year. Caucasian ethnicity had the highest incidence in both TCM and MI patients (58.2% vs. 47.2%) followed by African-American (17.9% vs. 14.8%) and Hispanic (16.4% vs. 25.4%). Lowest incidence was seen in Asians (7.5% vs. 12.6%). Higher TCM incidence rate was seen compared to MI for Caucasian and African-American, but lower incidence rate for Hispanic and Asian. The differences between TCM and MI in each ethnicity did not show statistically significant difference (p=0.20).
In our racially heterogeneous cohort of suspected MI, TCM incidence was 1.6% and majority of the patients were Caucasian, followed by African-American, Hispanic, and Asian. Higher trend in TCM incidence rate compared to MI was seen for Caucasian and African-American but lower trend in Hispanic and Asian. As TCM may be more common than reported and despite the difference of ethnic predominance by region, certain ethnic type should not preclude the possibility of TCM.