Key result
Takotsubo cardiomyopathy complicating stroke is linked to ~22% in-hospital mortality, longer stays, and higher costs.
Why the study?
Small observational studies suggested Takotsubo cardiomyopathy may be a risk factor for ischemic stroke, but broader national data were needed.
Does the presence of Takotsubo Cardiomyopathy in stroke patients worsen in-hospital outcomes?
Does the presence of Takotsubo Cardiomyopathy in stroke patients worsen in-hospital outcomes?
The co-occurrence of Takotsubo Cardiomyopathy and stroke is associated with significantly higher in-hospital mortality, longer length of stay, and increased healthcare costs.
TTC co-occurrence in stroke admissions signals higher mortality and costs; hypothesis-generating for prospective studies on screening and targeted management.
Background: Several case series and small observational studies have highlighted that Takotsubo Cardiomyopathy (TTC) might be a risk factor for Ischemic Stroke. This study aims to study the prevalence and incidence of stroke in TTC patients using the National Inpatient Sample Data. Methodology: We analysed the National Inpatient Sample data for the years 2016-2022 using STATA. The ICD-10 code I63 for stroke and I51. 81 for TTC were utilised. The prevalence was determined overall and yearly using descriptive statistics and employing the measures of central and peripheral tendencies. A survey-weighted regression analysis was performed to determine the independent factors associated with TTC. Furthermore, we used the Elixhauser comorbidity index for comorbidities. The p-value was kept significant at ≤ 0.05 with a 95% Confidence interval (CI). Results: Among stroke admissions (6,046,398), TTC was uncommon but present [0.279%, 95% CI: 0.268–0.290] and rose from 0.240% (2016) to 0.324% (2021–2022). Among TTC admissions, 5.78% (95% CI: 5.57–6.00) had a stroke, increasing from 4.99% in 2016 to 6.51% in 2021. Within the stroke cohort, TTC cases were more often female (74.7% vs 48.5%) and had worse outcomes: higher in-hospital mortality (21.7% vs 9.5%), longer length of stay (13.68 vs 7.36 days), and higher cost ($246,511 vs $111,325). Concomitant stroke was associated with higher odds of death [OR = 3.41, (95% CI: 3.08–3.78), p<0.001]. Furthermore, older age (OR = 1.016), atrial fibrillation (OR = 1.52), urban teaching hospitals ( OR = 1.47), and large bedsize (OR = 1.45) all increased the odds of mortality. Interestingly, female sex (OR = 0.48), hypertension (OR = 0.63), and ischemic heart disease (OR = 0.71) decreased the mortality. The length of stay was significantly increased among TTC patients [OR = 6.04 (95% CI 5.48–6.59) p<0.001]. The length of stay was lower among female patients (OR = 0.68) and ischemic heart disease (OR = 0.74). It was longer among atrial fibrillation patients (OR = 1.25), and care at urban teaching/large hospitals (OR = 2.36 and 2.0, respectively). Conclusion: The co-occurrence of TTC and stroke is associated with significant mortality and hospital stay. The overall incidence of TTC among stroke admissions is increasing, with factors such as older age and atrial fibrillation leading to worse outcomes.
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Maaz et al. (2026) studied this question. Among stroke admissions, Takotsubo Cardiomyopathy prevalence increased to 0.279% and was associated with 21.7% in-hospital mortality, higher costs, and longer stays.
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