Abstract 17446: Trends, Disparities, and Outcomes in Patients With Takotsubo Cardiomyopathy Complicated by Cardiogenic Shock

Introduction: Cardiogenic shock (CS), a highly fatal complication, is estimated to be seen in up to 20% of patients with Takotsubo cardiomyopathy (TC). Previous studies have found patients with TC to have similar mortality rates as those with acute myocardial infarction, highlighting the potential importance of therapeutic intervention. However, the existing literature on TC is limited.

Hypothesis: Minority patients with TC-CS are associated with increased mortality.

Methods: All adult admissions with a diagnosis of Takotsubo Cardiomyopathy and cardiogenic shock (TC-CS) were analyzed using the National Inpatient Sample Database between January 2016 and December 2019. Outcomes included in-hospital mortality, in-hospital complications, and resource use. We used multivariate logistics and Elixhauser co-morbidities to adjust for clinical comorbidities.

Results: Our study population included 37,902 patients with a diagnosis of Takotsubo cardiomyopathy. Of the sampled population, 2,455 (6.48%) experienced cardiogenic shock. Over the study time period, there was a significant increase in prevalence with TC-CS (p<0.001). Compared to patients with TC, patients with TC-CS were significantly associated with acute kidney injury (OR: 2.463, p<0.001). Controlling for baseline characteristics and Elixhauser comorbidities, Asians were at significantly higher odds of developing cardiogenic shock (OR: 1.859, p<0.001) and mortality, while Whites were at significantly decreased odds of developing cardiogenic shock (OR: 0.690, p<0.001). In addition, Asians who self-pay were at significantly higher odds (OR: 4.836, p=0.005) of developing cardiogenic shock compared with Asians holding insurance.

Conclusions: Our study offers insights into the disparities connected with TC-CS. There is a statistically significant increase in the trend of incidence of CS among patients with TC, and CS is associated with significantly higher odds of mortality. Notably, Asian individuals with TC face significantly higher odds of developing CS. However, there were no significant differences in hospitalization costs between races in patients with TC-CS.