RT Journal Article
SR Electronic
T1 Impact of family history of coronary artery disease on clinical outcomes in Takotsubo cardiomyopathy
JF Journal of Investigative Medicine
JO J Investig Med
FD BMJ Publishing Group Ltd
SP jim-2021-002186
DO 10.1136/jim-2021-002186
A1 Pengyang Li
A1 Chengyue Jin
A1 Can Cui
A1 Peng Cai
A1 Shamita Alisa Manohar
A1 Ling Jin
A1 Xin Wei
A1 Su Pan
A1 Richard A F Dixon
A1 Qi Liu
YR 2022
UL http://hw-f5-jim.highwire.org/content/early/2022/07/18/jim-2021-002186.abstract
AB Family history of coronary artery disease (FHxCAD) is a critical risk factor for CAD, underscoring the contribution of genetic factors to disease pathogenesis and susceptibility. Takotsubo cardiomyopathy (TCM) simulates the clinical features of and frequently coexists with CAD. However, the association between FHxCAD and TCM is unclear. Here, we retrospectively examined the impact of FHxCAD on in-hospital outcomes of patients with TCM. Using the National Inpatient Sample database (2016–2018), we identified 4733 patients admitted to hospital with a primary diagnosis of TCM. We compared in-hospital outcomes and complications between TCM patients with (n=646, 13.7%) and without FHxCAD (n=646) in the unmatched and in a propensity-score matched cohort (1:1 ratio). TCM with FHxCAD patients had a reduced incidence of cardiogenic shock, acute kidney injury (AKI), and acute respiratory failure (ARF); lower mortality rates; shorter length of stay (LOS); and decreased total charge compared with TCM without FHxCAD patients (p<0.05). In the matched cohort, TCM with FHxCAD patients (vs TCM without FHxCAD patients) had a lower incidence of cardiogenic shock (2.2% vs 6.3%, p<0.001; OR 0.33, 95% CI 0.18 to 0.61), AKI (5.1% vs 8.7%, p=0.016; OR 0.57, 95% CI 0.36 to 0.88), and ARF (5.7% vs 12.7%, p<0.001; OR 0.42, 95% CI 0.28 to 0.63); decreased in-hospital mortality (<11% vs 3.1%, p=0.002; OR 0.2, 95% CI 0.07 to 0.57); shorter LOS (2.66±1.96 days vs 3.40±3.05 days, p<0.001); and a reduced total charge (p=0.001), respectively. FHxCAD was associated with favorable outcomes in both unmatched and propensity-matched cohorts.Data are available in a public, open access repository. Reference 20: Agency for Healthcare Research and Quality. HCUP Databases. Healthcare Cost and Utilization Project (HCUP) (website). August 2018. Available at: www.hcup-us.ahrq.gov/nisoverview.jsp. Accessed 13 December 2018.