Abstract 16174: The Epidemiology of Takotsubo Cardiomyopathy: A Case-Control Study from the National Inpatient Sample

Abstract

Background: Takotsubo Cardiomyopathy (TC) is characterized by acute chest pain and reversible left ventricular apical ballooning. We sought to characterize the population-level predictors of TC, as well as differences and similarities in the determinants of TC relative to MI. Materials and

Methods: Using patients from the National Inpatient Sample Database, we employed a three-arm, case-control study to assess demographic and comorbid predictors of TC relative to age-matched control patients with MI and control patients with traumatic joint injury. Traumatic joint injury patients were used as a surrogate for the general population. We used McNemar’s tests to assess differences in demographic characteristics and comorbidities between TC patients and controls.

Results: 24,701 TC patients, 25,069 MI patients and 24,601 orthopedic control patients were included in this study. TC patients, when compared to MI and orthopedic controls, were more likely to be female (89.0% vs. 38.9% and 55.7% respectively, P<0.0001) and White (84.0% vs. 76.8% and 80.9 respectively, P<0.0001). TC patients were less likely to have any cardiovascular risk factors (72.0% vs. 89.3% and 75.4%, P<0.0001), but were more likely to have co-morbid diagnoses of malignancy (14.4% versus 10.0% and 8.8%, P<0.0001), anxiety disorders (8.9% versus 3.4% and 3.7%, P<0.0001) mood disorders (15.0% versus 7.2% and 11.9%, P<0.0001), and sepsis (7.1% versus 2.5% and 0.6%, P<0.0001)).

Conclusions: Our study suggests that Whites and females may have higher incidence of TC. Etiologic factors of interest include anxiety and mood disorders, malignancy, and sepsis. Demographic and comorbid predictors of TC differ substantially from those of MI, which may be of interest to providers when diagnosing TC. This is the first study to systematically study epidemiologic risk factors of TC. These findings have important implications for future research about the etiology of TC.