Body Mass Index and Outcomes in Patients with Takotsubo Syndrome: A Nationwide Retrospective Cohort Study.

IF 1.9 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Cardiology Pub Date : 2024-01-01 Epub Date: 2024-02-22 DOI:10.1159/000537971
Toshiaki Isogai, Akira Okada, Kojiro Morita, Nobuaki Michihata, Kanako Makito, Hiroki Matsui, Kiyohide Fushimi, Hideo Yasunaga
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引用次数: 0

Abstract

Background: Takotsubo syndrome (TTS) is a cardiac disorder that mimics acute coronary syndrome at presentation. While previous studies have demonstrated a relationship between body mass index (BMI) and outcomes in acute coronary syndrome, few have examined its relationship with TTS.

Methods: Using the Japanese Diagnosis Procedure Combination database, we retrospectively identified 14,551 patients admitted for TTS between 2010 and 2021. By applying multivariable regressions with restricted cubic splines, we examined the association between BMI and in-hospital mortality after adjusting for potential confounders.

Results: Mean BMI was 21.1 kg/m2, classifying patients into severe underweight (<16.0 kg/m2, 7.1%), mild/moderate underweight (16.0-18.4 kg/m2, 18.3%), normal weight (18.5-22.9 kg/m2, 46.8%), overweight (23.0-27.4 kg/m2, 22.2%), and obese (≥27.5 kg/m2, 5.6%) groups. Patients with severe or mild/moderate underweight were older and had a higher prevalence of impaired physical activity, malignancy, chronic pulmonary disease, and pneumonia. In-hospital mortality was the highest (9.4%) in the severe underweight group, followed by the mild/moderate underweight group (5.4%), with the lowest being in the obese group (2.1%). Severe underweight (adjusted odds ratio = 2.05; 95% confidence interval [CI] = 1.54-2.73) and mild/moderate underweight (1.26; 95% CI = 1.01-1.57) were significantly associated with higher mortality compared with normal weight, while no significant association was noted with obesity. A nonlinear association between continuous BMI and mortality was observed, with mortality increasing when BMI decreased <20.0 kg/m2 but nearly plateauing in BMI >20.0 kg/m2.

Conclusions: The present nationwide analysis demonstrated a nonlinear association between BMI and in-hospital mortality of TTS. BMI is an easily available and clinically relevant marker for the risk stratification of TTS.

Takotsubo综合征患者的体重指数和预后:一项全国性回顾性队列研究。
背景:塔克次氏综合征(TTS)是一种心脏疾病,发病时与急性冠状动脉综合征相似。以往的研究表明,体重指数(BMI)与急性冠状动脉综合征的预后有一定关系,但很少有人研究过体重指数与 TTS 的关系:我们利用日本诊断程序组合数据库,回顾性地识别了 2010-2021 年间因 TTS 入院的 14551 名患者。在调整了潜在的混杂因素后,我们利用限制性立方样条进行多变量回归,研究了 BMI 与院内死亡率之间的关系:平均体重指数为 21.1 kg/m2,将患者划分为严重体重不足(20 kg/m2):本项全国性分析表明,体重指数与 TTS 的院内死亡率之间存在非线性关系。体重指数是一种易于获得且与临床相关的 TTS 风险分层指标。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Cardiology
Cardiology 医学-心血管系统
CiteScore
3.40
自引率
5.30%
发文量
56
审稿时长
1.5 months
期刊介绍: ''Cardiology'' features first reports on original clinical, preclinical and fundamental research as well as ''Novel Insights from Clinical Experience'' and topical comprehensive reviews in selected areas of cardiovascular disease. ''Editorial Comments'' provide a critical but positive evaluation of a recent article. Papers not only describe but offer critical appraisals of new developments in non-invasive and invasive diagnostic methods and in pharmacologic, nutritional and mechanical/surgical therapies. Readers are thus kept informed of current strategies in the prevention, recognition and treatment of heart disease. Special sections in a variety of subspecialty areas reinforce the journal''s value as a complete record of recent progress for all cardiologists, internists, cardiac surgeons, clinical physiologists, pharmacologists and professionals in other areas of medicine interested in current activity in cardiovascular diseases.
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