Abstract 20533: Gender and Race Differences in Patient Characteristics and Outcomes in 10,582 Hospitalizations for Takotsubo Cardiomyopathy
Introduction: Takotsubo cardiomyopathy (TTCM) is characterized by acute, reversible left ventricular dysfunction in the absence of epicardial coronary artery occlusion. Because of its rarity, little is known about age, gender and race differences in patients with TTCM.
Objectives: To describe gender and race differences in TTCM
Methods: Deidentified hospital data from California, New York, New Jersey, Vermont, New Hampshire, West Virginia, and Colorado between 2006 and 2012 were harmonized, and hospital records reporting the ICD-9 code 429.83 (takotsubo cardiomyopathy) were analyzed. Demographics, comorbid conditions, and in-hospital outcomes including death and major adverse events (MAE) defined as death, mechanical ventilation, cardiac arrest, shock, or placement of intra-aortic balloon bump were stratified according to race and gender. Characteristics independently associated with death and MAEs were identified using multivariate logistic regression.
Results: In total, 10,582 TTCM cases were identified including 1077 (11.4%) men and 8350 (88.6%) women (1155 not available). Where race was reported, 5960 (70.7%) were white, 1266 (15.0%) had African Ancestry (AA), 291 (2.7%) were Asian, 748 (7.1%) were Hispanic, and 162 (1.5%) were of other or mixed race. Women were significantly older than men (p<0.001) and Asians were older than other races (p<0.01). Significant gender- and race-based differences were noted with respect to concomitant substance abuse, COPD, mood disorders, hypertension, and thyroid disease, whereas significant race-based differences were also observed with respect to anemia, atrial fibrillation, and heart failure. Overall mortality was 4.4% and rate of MAEs was 21.6%. In multivariate analysis, male gender and Asian race were significantly associated with both death (OR 2.26 [1.72-2.98], p<0.001 and OR 1.80, [1.12-2.87], p=0.01 respectively) and MAEs (OR 1.80 [1.54-2.10], p<0.001 and OR 1.35, [1.02-1.79], p=0.03 respectively).
Conclusions: There are significant gender- and race-based differences in patient characteristics and adverse outcomes in patients hospitalized with TTCM. Further study of these differences may yield insight into the pathophysiology of this increasingly recognized disorder.
Author Disclosures: D.P. Kao: None. J. Lindenfeld: None.
- © 2014 by American Heart Association, Inc.