Abstract P120: Prevalence of Psychiatric Disorders and In-Hospital Recovery Among Women with Stress Cardiomyopathy
Background Stress cardiomyopathy (SC) is a reversible condition mimicking acute myocardial infarction usually affecting postmenopausal women and often triggered by emotional or physical stress. The overall prevalence of antecedent psychiatric disorders among these patients is not clear, and it is unknown whether such a history may affect the in-hospital prognosis of SC. The aims of this study were: 1) to determine the prevalence of psychiatric disorders in women with SC and 2) to compare in-hospital survival and EF (ejection fraction, %) at the discharge echocardiogram between women with psychiatric disorders (psyc+) vs. women without such a history (psyc-).
Methods We reviewed the charts of consecutive patients hospitalized at UMass Memorial Medical Center (Worcester, MA) with an ICD-9 code of 429.83 (Takotsubo cardiomyopathy) from 01/2002 until 05/2012 and identified women whose diagnosis met Mayo clinic criteria. Information regarding psychiatric history and relevant clinical data was abstracted from the medical record. Multivariate linear regression models were used to estimate between-group differences in EF.
Results A total of 49 women had a diagnosis of SC meeting Mayo criteria. Among these women [94% (46/49) white; 6% (3/49) Hispanic; 51% (25/49) married; mean age, 65 years], 60% (30/49) had a history of psychiatric disorders: mood disorder, 17%; psychosis, 2%; anxiety disorder, 26%; co-morbid anxiety and mood disorder, 15%. Compared with psyc- women, psyc+ were more frequently single (46% vs. 29%); hypertensive (72% vs. 56%); current smokers (28% vs. 6%); used psychotropic drugs (100% vs. 0); and had lower peak CK levels (245 vs. 342). Other baseline characteristics including EF were similar between the two groups. There were no in-hospital deaths. Multivariate models adjusted for demographics, coronary risk factors, peak CK, and use of psychotropic drugs showed that psyc+ vs. psyc- women had a higher EF at discharge (β=13.3%, CI 1.7%, 24.9%).
Conclusion In this sample of female patients with Mayo criteria SC, the majority had a history of anxiety and mood disorders preceding the onset of SC. Compared with women with no psychiatric history, women with such a history had a higher EF at discharge suggesting that these women may have a more favorable prognosis.
- © 2013 by American Heart Association, Inc.