Abstract Body (Do not enter title and authors here): Background
Takotsubo cardiomyopathy (TTC) is characterized by impaired left ventricular function due to typical, regional wall motion abnormalities in the absence of significant obstructive coronary artery disease. Previous small-sized retrospective studies reported favorable outcomes of cardiogenic shock in patients with TTC. We aimed to investigate whether the presence of TTC is associated with a favorable in-hospital outcome among patients admitted for cardiogenic shock using a large nationally representative dataset.
Methods
Utilizing data from the National Inpatient Sample (NIS) spanning from 2016 to 2020, we identified patients admitted for cardiogenic shock using ICD-10 codes. Patients with TTC were also identified using ICD-10 codes. Using sociodemographic variables, and comorbid medical conditions, and performed procedures as matching variables, we conducted a 1:1 nearest-neighbor propensity score matching to mitigate potential confounders. The success of matching was evaluated based on standardized mean differences. In-hospital mortality was the primary outcome, while in-hospital complications, length of stay (LOS), and cost of hospitalization were secondary outcomes. We employed the Cochrane-Mantel-Haenszel method to assess the odds ratio (OR) for in-hospital mortality and complications. Simple linear regression models were used to evaluate differences in LOS and cost of hospitalization.
Results
The final sample included 22,594 patients, evenly distributed between the groups with and without TTC. The mean age of the cohort was 65.4 years (SD = 15.9), with 74.7% being males. Ethnic composition indicated 75.7% Whites, 9.3% Blacks, and 8.1% Hispanics. The overall in-hospital mortality rate was 32.7%. The TTS group had a lower mortality rate (38.4% Vs 27%, p<0.001). Patients with TTC had lower odds of in-hospital mortality, cardiac arrest, ventricular tachycardia, and acute kidney injury. However, they were noted to have higher odds of deep vein thrombosis, stroke, slightly higher LOS, and cost of hospitalization.
Conclusion
In summary, our study suggests that Takotsubo Cardiomyopathy is associated with significantly lower in-hospital mortality rates among patients admitted for cardiogenic shock, indicating a favorable prognosis in this clinical setting.