Abstract 14971: Outcomes and Characteristics of Patients with Critical Illness Associated Takotsubo Cardiomyopathy Compared to Non-Critical Illness Associated Takotsubo Cardiomyopathy

Abstract

Background: Takotsubo Cardiomyopathy (TC) has been described in the context of critical illness as well as emotional distress. We compared outcomes and characteristics of patients diagnosed with TC in the context of underlying critical illness to those patients without critical illness.

Methods: Using the National Inpatient Sample years 2008-2009 we selected all patients diagnosed with TC. Patients were divided into two groups: 1) those with underlying critical illnesses (respiratory insufficiency, acute renal failure, sepsis, cerebrovascular accident) and 2) those without underlying critical illnesses. We studied demographic characteristics of the two groups, and in-hospital mortality.

Results: 5353 patients (21.7%) had critical illness associated TC and 19348 with non-critical illness TC (78.3%). Mean age was similar between groups. Critical illness TC mortality rate was 15.2% compared to 1.1% for non-critical illness TC (P<0001). 15.8% of critical illness TC patients were male compared to 9.6% in the non-critical illness cohort (P<.0001). 16.5% of patients in the critical illness group were racial minorities compared to 12.4% in the non-critical illness group (P<.0001). Non-critical illness TC patients had a higher rate of cardiovascular risk factors (78.9% versus 62.5%, P<.0001), mood disorders (15.8% versus 11.9%, P<.0001), and anxiety disorders (10.2% versus 4.2%, P<.0001). Patients in the critical illness group had higher rates of malignancy (16.7% versus 13.7%, P<.0001) and chronic kidney disease (CKD) (14.4% versus 4.8%, P<.0001).

Conclusions: TC pts who had associated critical illness make up a significant minority of the cohort, however they are responsible for nearly 80% of the in-hospital mortality rate associated with this condition. Risk factors for critical illness associated TC include male gender, malignancy, CKD and minority race.