Prognostic implications of takotsubo cardiomyopathy in cardiogenic shock: A propensity score-matched analysis of the national inpatient sample (2016–2020)

Abstract

Background

Takotsubo cardiomyopathy (TTC), also called stress-induced cardiomyopathy, characterized by transient acute systolic dysfunction mimicking myocardial infarction in the absence of obstructive coronary artery disease, is a recognized cause of cardiogenic shock.

Objectives

This study aimed to investigate whether TTC is associated with favorable in-hospital outcomes in patients admitted for cardiogenic shock.

Methods

We used National Inpatient Sample (2016–2020) data to identify admissions with cardiogenic shock and Takotsubo syndrome (TTC) using ICD-10 codes. A 1:1 nearest-neighbor propensity score matching was performed with sociodemographic and clinical variables as matching factors. All-cause in-hospital mortality was the primary outcome, and secondary outcomes included in-hospital complications, length of stay (LOS), and total cost of hospitalization.

Results

The final sample included 22,594 admissions, evenly distributed between the groups with and without TTC. The cohort’s mean age was 65.4 years (SD = 15.9), with 74.7 % being males. The overall in-hospital mortality rate was 32.7 %. The TTC group had a lower overall in-hospital mortality rate (OR = 0.60; 95 % CI [0.56, 0.63]) and 30-day in-hospital mortality rate (HR = 0.61; 95 % CI [0.59, 0.64]). Admissions with TTC had lower odds of in-hospital complications, including cardiac arrest, ventricular arrhythmia, and acute kidney injury. However, they were noted to have higher odds of deep vein thrombosis, ischemic stroke, intracranial hemorrhage, and a marginally higher LOS, and total cost of hospitalizations.

Conclusion

Our study suggests that TTC is associated with significantly lower in-hospital mortality rates among cardiogenic shock admissions.