Trends in hospitalization for takotsubo cardiomyopathy in the United States

Rohan Khera, Kelly Ann Light-Mcgroary, Firas Zahr, Phillip A. Horwitz, Saket Girotra

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Background Takotsubo (or stress induced) cardiomyopathy is characterized by transient left ventricular systolic dysfunction. Recent trends in patient volume, characteristics, and outcomes in the United States are unknown. Methods Using 2007-2012 National Inpatient Sample data, we identified 22,005 adults (≥18 years) with a primary and 31,942 adults with a secondary discharge diagnosis of takotsubo cardiomyopathy (International Classification of Diseases, Ninth Revision, code 429.83) who underwent diagnostic coronary angiography. Results During 2007 to 2012, the incidence of takotsubo cardiomyopathy increased over 3-fold: 52/million discharges in 2007 to 178/million in 2012 (P <.001). We found a temporal increase in the prevalence of cardiac arrest, cardiogenic shock, cardiovascular risk factors (diabetes, hypertension), and psychiatric disorders (P trend <.0001 for all). In-hospital mortality was 1.1% and remained unchanged over this period (P =.22). Compared to the primary diagnosis group, mortality in the secondary diagnosis group was higher (1.1% vs 3.2%) and was associated with higher incidence of cardiogenic shock, cardiac arrest, and respiratory failure. Men represent 8% of patients in the primary diagnosis group and 12% in the secondary group. In both groups, men had a higher incidence of shock, cardiac arrest, and respiratory failure. Although their mortality was higher than women in the primary group (3.0% vs 0.9%, adjusted odds ratio 3.85, 1.74-8.51), it was comparable in the secondary group (4.8% vs 3.0%). Conclusions We found a marked increase in the hospitalization for takotsubo cardiomyopathy in the United States in recent years, suggesting higher incidence than prior reports. Although outcomes have remained favorable, there is an increasing burden of cardiovascular and psychiatric disorders in this population with growing cost of care. Risk of mortality is higher in men and in patients with underlying critical illness. The excess mortality in these groups appears to be mediated by greater severity of disease.

Original languageEnglish (US)
Pages (from-to)53-63
Number of pages11
JournalAmerican Heart Journal
Volume172
DOIs
StatePublished - Feb 1 2016
Externally publishedYes

Fingerprint

Takotsubo Cardiomyopathy
Hospitalization
Heart Arrest
Cardiogenic Shock
Mortality
Incidence
Respiratory Insufficiency
Psychiatry
Heart Failure
Left Ventricular Dysfunction
International Classification of Diseases
Hospital Mortality
Coronary Angiography
Critical Illness
Inpatients
Shock
Odds Ratio
Hypertension
Costs and Cost Analysis
Population

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Trends in hospitalization for takotsubo cardiomyopathy in the United States. / Khera, Rohan; Light-Mcgroary, Kelly Ann; Zahr, Firas; Horwitz, Phillip A.; Girotra, Saket.

In: American Heart Journal, Vol. 172, 01.02.2016, p. 53-63.

Research output: Contribution to journalArticle

Khera, Rohan ; Light-Mcgroary, Kelly Ann ; Zahr, Firas ; Horwitz, Phillip A. ; Girotra, Saket. / Trends in hospitalization for takotsubo cardiomyopathy in the United States. In: American Heart Journal. 2016 ; Vol. 172. pp. 53-63.
@article{566786c32ced4ae686fbe4b78843b6fe,
title = "Trends in hospitalization for takotsubo cardiomyopathy in the United States",
abstract = "Background Takotsubo (or stress induced) cardiomyopathy is characterized by transient left ventricular systolic dysfunction. Recent trends in patient volume, characteristics, and outcomes in the United States are unknown. Methods Using 2007-2012 National Inpatient Sample data, we identified 22,005 adults (≥18 years) with a primary and 31,942 adults with a secondary discharge diagnosis of takotsubo cardiomyopathy (International Classification of Diseases, Ninth Revision, code 429.83) who underwent diagnostic coronary angiography. Results During 2007 to 2012, the incidence of takotsubo cardiomyopathy increased over 3-fold: 52/million discharges in 2007 to 178/million in 2012 (P <.001). We found a temporal increase in the prevalence of cardiac arrest, cardiogenic shock, cardiovascular risk factors (diabetes, hypertension), and psychiatric disorders (P trend <.0001 for all). In-hospital mortality was 1.1{\%} and remained unchanged over this period (P =.22). Compared to the primary diagnosis group, mortality in the secondary diagnosis group was higher (1.1{\%} vs 3.2{\%}) and was associated with higher incidence of cardiogenic shock, cardiac arrest, and respiratory failure. Men represent 8{\%} of patients in the primary diagnosis group and 12{\%} in the secondary group. In both groups, men had a higher incidence of shock, cardiac arrest, and respiratory failure. Although their mortality was higher than women in the primary group (3.0{\%} vs 0.9{\%}, adjusted odds ratio 3.85, 1.74-8.51), it was comparable in the secondary group (4.8{\%} vs 3.0{\%}). Conclusions We found a marked increase in the hospitalization for takotsubo cardiomyopathy in the United States in recent years, suggesting higher incidence than prior reports. Although outcomes have remained favorable, there is an increasing burden of cardiovascular and psychiatric disorders in this population with growing cost of care. Risk of mortality is higher in men and in patients with underlying critical illness. The excess mortality in these groups appears to be mediated by greater severity of disease.",
author = "Rohan Khera and Light-Mcgroary, {Kelly Ann} and Firas Zahr and Horwitz, {Phillip A.} and Saket Girotra",
year = "2016",
month = "2",
day = "1",
doi = "10.1016/j.ahj.2015.10.022",
language = "English (US)",
volume = "172",
pages = "53--63",
journal = "American Heart Journal",
issn = "0002-8703",
publisher = "Mosby Inc.",

}

TY - JOUR

T1 - Trends in hospitalization for takotsubo cardiomyopathy in the United States

AU - Khera, Rohan

AU - Light-Mcgroary, Kelly Ann

AU - Zahr, Firas

AU - Horwitz, Phillip A.

AU - Girotra, Saket

PY - 2016/2/1

Y1 - 2016/2/1

N2 - Background Takotsubo (or stress induced) cardiomyopathy is characterized by transient left ventricular systolic dysfunction. Recent trends in patient volume, characteristics, and outcomes in the United States are unknown. Methods Using 2007-2012 National Inpatient Sample data, we identified 22,005 adults (≥18 years) with a primary and 31,942 adults with a secondary discharge diagnosis of takotsubo cardiomyopathy (International Classification of Diseases, Ninth Revision, code 429.83) who underwent diagnostic coronary angiography. Results During 2007 to 2012, the incidence of takotsubo cardiomyopathy increased over 3-fold: 52/million discharges in 2007 to 178/million in 2012 (P <.001). We found a temporal increase in the prevalence of cardiac arrest, cardiogenic shock, cardiovascular risk factors (diabetes, hypertension), and psychiatric disorders (P trend <.0001 for all). In-hospital mortality was 1.1% and remained unchanged over this period (P =.22). Compared to the primary diagnosis group, mortality in the secondary diagnosis group was higher (1.1% vs 3.2%) and was associated with higher incidence of cardiogenic shock, cardiac arrest, and respiratory failure. Men represent 8% of patients in the primary diagnosis group and 12% in the secondary group. In both groups, men had a higher incidence of shock, cardiac arrest, and respiratory failure. Although their mortality was higher than women in the primary group (3.0% vs 0.9%, adjusted odds ratio 3.85, 1.74-8.51), it was comparable in the secondary group (4.8% vs 3.0%). Conclusions We found a marked increase in the hospitalization for takotsubo cardiomyopathy in the United States in recent years, suggesting higher incidence than prior reports. Although outcomes have remained favorable, there is an increasing burden of cardiovascular and psychiatric disorders in this population with growing cost of care. Risk of mortality is higher in men and in patients with underlying critical illness. The excess mortality in these groups appears to be mediated by greater severity of disease.

AB - Background Takotsubo (or stress induced) cardiomyopathy is characterized by transient left ventricular systolic dysfunction. Recent trends in patient volume, characteristics, and outcomes in the United States are unknown. Methods Using 2007-2012 National Inpatient Sample data, we identified 22,005 adults (≥18 years) with a primary and 31,942 adults with a secondary discharge diagnosis of takotsubo cardiomyopathy (International Classification of Diseases, Ninth Revision, code 429.83) who underwent diagnostic coronary angiography. Results During 2007 to 2012, the incidence of takotsubo cardiomyopathy increased over 3-fold: 52/million discharges in 2007 to 178/million in 2012 (P <.001). We found a temporal increase in the prevalence of cardiac arrest, cardiogenic shock, cardiovascular risk factors (diabetes, hypertension), and psychiatric disorders (P trend <.0001 for all). In-hospital mortality was 1.1% and remained unchanged over this period (P =.22). Compared to the primary diagnosis group, mortality in the secondary diagnosis group was higher (1.1% vs 3.2%) and was associated with higher incidence of cardiogenic shock, cardiac arrest, and respiratory failure. Men represent 8% of patients in the primary diagnosis group and 12% in the secondary group. In both groups, men had a higher incidence of shock, cardiac arrest, and respiratory failure. Although their mortality was higher than women in the primary group (3.0% vs 0.9%, adjusted odds ratio 3.85, 1.74-8.51), it was comparable in the secondary group (4.8% vs 3.0%). Conclusions We found a marked increase in the hospitalization for takotsubo cardiomyopathy in the United States in recent years, suggesting higher incidence than prior reports. Although outcomes have remained favorable, there is an increasing burden of cardiovascular and psychiatric disorders in this population with growing cost of care. Risk of mortality is higher in men and in patients with underlying critical illness. The excess mortality in these groups appears to be mediated by greater severity of disease.

UR - http://www.scopus.com/inward/record.url?scp=84959564196&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84959564196&partnerID=8YFLogxK

U2 - 10.1016/j.ahj.2015.10.022

DO - 10.1016/j.ahj.2015.10.022

M3 - Article

C2 - 26856216

AN - SCOPUS:84959564196

VL - 172

SP - 53

EP - 63

JO - American Heart Journal

JF - American Heart Journal

SN - 0002-8703

ER -