Key result
Family history of coronary artery disease in Takotsubo cardiomyopathy patients was associated with a lower incidence of cardiogenic shock (2.2% vs 6.3%; OR 0.33, 95% CI 0.18-0.61; p<0.001).
Why the study?
Takotsubo cardiomyopathy simulates features of and coexists with CAD, but the association between a family history of coronary artery disease and Takotsubo cardiomyopathy is unclear.
Does a family history of coronary artery disease improve in-hospital outcomes in patients with Takotsubo cardiomyopathy?
Cohort (n=4,733)
Yes
Does a family history of coronary artery disease improve in-hospital outcomes in patients with Takotsubo cardiomyopathy?
Odds Ratio: 0.33 (95% CI 0.18–0.61)
Absolute Event Rate: 2.2% vs 6.3%
p-value: p=<0.001
A family history of coronary artery disease is paradoxically associated with more favorable in-hospital outcomes and lower mortality in patients presenting with Takotsubo cardiomyopathy.
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.
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Li et al. (2022) conducted a cohort in Takotsubo cardiomyopathy (n=4,733). Family history of coronary artery disease vs. No family history of coronary artery disease was evaluated on Cardiogenic shock (OR 0.33, 95% CI 0.18 to 0.61, p=<0.001). Family history of coronary artery disease in Takotsubo cardiomyopathy patients was associated with a lower incidence of cardiogenic shock (2.2% vs 6.3%; OR 0.33, 95% CI 0.18-0.61; p<0.001).
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