Takotsubo cardiomyopathy with Cirrhosis - Mortality and Outcomes among hospitalised patients in the United States
Abstract Body (Do not enter title and authors here): Background Takotsubo cardiomyopathy (TCM) is a unique and reversible heart condition typically triggered by intense emotional or physical stress. Meanwhile, Cirrhosis, a chronic liver disease, is associated with increasing inflammation and oxidative stress, which can potentially worsen cardiovascular problems. In this study, we aimed to study the impact of cirrhosis on outcomes in TCM. Methods A retrospective analysis was performed using the NIS database 2016 -2020 and the International Classification of Diseases, Tenth Revision codes to identify patients > 18 years old with the principal diagnosis of Takotsubo cardiomyopathy. The effect of cirrhosis was studied on in-hospital mortality and secondary outcomes such as cardiogenic shock, ventricular arrhythmia (VA), acute respiratory and acute kidney injury (AKI), as well as resource utilisation. Categorical variables were compared using the chi-square test, and continuous variables were compared using the t-test—multivariable regression analyses adjusted for demographics, hospital-level characteristics, and relevant comorbidities. Results We identified a total of 190,025 patients with TCM. Of these, 3,335 (1.76%) patients had liver cirrhosis, with notably higher prevalence of diabetes (33.6%), CKD (20.7%), anemia (10.2%), and major depressive disorder (25.6%) in the cirrhosis group. A higher incidence of in-hospital mortality (12.9% vs. 6.3%, p<0.001), cardiogenic shock (11.7% vs. 6.5%, p<0.001), AKI (41.4% vs. 22.8%, p<0.001), and ARF (40% vs. 31.6%) was noted in the cirrhosis group. After adjusting for confounding factors, the liver cirrhosis group had higher odds of in-hospital mortality (aOR 1.39, 95% CI 1.1-1.75, p=0.006), AKI (aOR 1.53, 95% CI 1.28-1.82, p<0.001), longer length of stay (11.2 days vs. 6.8 days, p<0.001), and higher total hospitalization charges ($198,786 vs. $99,712, p<0.001). The relationship between cirrhosis and cardiovascular outcomes such as cardiogenic shock (aOR 1.23, 95% CI 0.95-1.58, p=0.116) and VA (aOR 1.01, 95% CI 0.75-1.36, p=0.942) was not statistically significant. Discussion Our study noted that TCM patients with cirrhosis had higher in-hospital mortality and resource utilization. There was no statistically significant relationship between cirrhosis and cardiovascular outcomes suggestive of the adverse consequences to be related to cirrhosis itself rather than TCM.
Hotwani, Priya
( Parkview Health -IN
, Fort Wayne
, Indiana
, United States
)
Sanka, Sujana
( The Brooklyn Hospital Center
, Brooklyn
, New York
, United States
)
Borse, Tanvi
( Parkview Health -IN
, Fort Wayne
, Indiana
, United States
)
Alvarez, Andy
( Parkview Regional Medical Center
, Fort Wayne
, Indiana
, United States
)
Habib, Anwer
( EMORY UNIVERSITY
, Pine Lake
, Georgia
, United States
)
Alraies, M Chadi
( Detroit Medical Center
, Detroit
, Michigan
, United States
)
Author Disclosures:
Priya Hotwani:DO NOT have relevant financial relationships
| Sujana Sanka:DO NOT have relevant financial relationships
| Tanvi Borse:DO NOT have relevant financial relationships
| Andy Alvarez:DO NOT have relevant financial relationships
| Anwer Habib:DO NOT have relevant financial relationships
| M Chadi Alraies:DO NOT have relevant financial relationships
