Trends and cardiovascular outcomes of Takotsubo syndrome with cardiogenic shock vs. mixed cardiogenic and septic shock: a nationwide propensity matched analysis

Department

Internal Medicine

Additional Department

Cardiology

Document Type

Article

Publication Title

Expert Review of Cardiovascular Therapy

Abstract

Introduction: Takotsubo syndrome (TTS), also known as stress-induced cardiomyopathy, can be complicated by shock. The outcomes of patients with TTS complicated with cardiogenic shock (CS) versus mixed cardiogenic and septic shock (MS) is not known.

Methods: We queried Nationwide Inpatient Sample (NIS) from 2009-2020 to compare TTS patients with CS and MS using International Classification of Disease, Ninth & Tenth Edition, Clinical Modification (ICD- 9 & 10-CM) coding. In-hospital outcomes were compared using one: one propensity score matched (PSM) analysis. The primary outcome was in-hospital mortality.

Results: Of 23,126 patients with TTS 17,132 (74%) had CS, and 6,269 (26%) had MS. The mean age was 67 years in CS and 66 years in MS, and majority of patients were female (n = 17,775, 77%). On adjusted multivariate analysis, MS patients had higher odds of in-hospital mortality (aOR 1.44, 95% CI 1.36-1.52), AKI (aOR 1.53, 95% CI 1.48-1.58), pressor requirement (aOR 1.37, 95% CI 1.25-1.50). However, had lower odds of MCS use (aOR 0.44, 95% CI 0.40-0.48) and cardiac arrest (aOR: 0.81, 95% CI 0.73-0.90) (p-value < 0.0001). Mean LOS and inflation-adjusted hospital charges were higher in MS.

Conclusion: MS in the setting of TTS have higher rates of in-hospital mortality, AKI, and pressor requirements.

First Page

103

Last Page

109

DOI

10.1080/14779072.2023.2295378

Volume

22

Issue

1-3

Publication Date

1-1-2024

Medical Subject Headings

Humans; Male; Female; Aged; Shock, Cardiogenic; Takotsubo Cardiomyopathy (complications); Shock, Septic (complications); Heart Arrest; Acute Kidney Injury; Hospital Mortality

PubMed ID

38105722

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