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

Authors

Sadaf Fakhra, Department of Internal Medicine, University of Nevada, Reno, NV, USA.
Mohammed Faisaluddin, Rochester Regional HealthFollow
Yasar Sattar, Department of Cardiology, West Virginia University, Morgantown, WV, USA.
Danielle DeCicco, Department of Cardiology, West Virginia University, Morgantown, WV, USA.
Asmaa Ahmed, Rochester Regional HealthFollow
Neel Patel, Department of Internal Medicine, New York Medical College/Landmark Medical Center, Woonsocket, RI, USA.
Senthil Balasubramanian, Division of Cardiovascular Medicine, NorthShore University Health System-Metro Chicago, Evanston, IL, USA.
Dipesh Ludhwani, Department of Cardiology, West Virginia University, Morgantown, WV, USA.
Hassan Masood, Department of Critical Care, Pakistan Railway Hospital, Rawalpindi, Pakistan.
Sameer Raina, Department of Cardiology, West Virginia University, Morgantown, WV, USA.
Karthik Gonuguntla, Department of Cardiology, West Virginia University, Morgantown, WV, USA.
Scott C. Feitell, Rochester Regional HealthFollow
Tushar Tarun, Division of cardiovascular medicine, University of Arkansas School of Medicine, Little Rock, AR, USA.
Sudarshan Balla, Department of Cardiology, West Virginia University, Morgantown, WV, USA.

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

Recommended Citation

Fakhra, S., Faisaluddin, M., Sattar, Y., DeCicco, D., Ahmed, A., Patel, N., Balasubramanian, S., Ludhwani, D., Masood, H., Raina, S., Gonuguntla, K., Feitell, S. C., Tarun, T., & Balla, S. (2024). Trends and cardiovascular outcomes of Takotsubo syndrome with cardiogenic shock vs. mixed cardiogenic and septic shock: a nationwide propensity matched analysis. Expert Review of Cardiovascular Therapy, 22 (1-3), 103-109. https://doi.org/10.1080/14779072.2023.2295378