Key result
In patients with Takotsubo cardiomyopathy, in-hospital mortality was higher in men than women, while acute respiratory failure and acute CVA strongly predicted death.
Observational (n=7,510)
Yes
Men with Takotsubo cardiomyopathy experience higher in-hospital mortality than women, largely driven by a higher prevalence of acute critical illnesses such as sepsis, respiratory failure, and stroke.
Answers are grounded in this paper and cite their sources.
Higher in-hospital mortality in men with Takotsubo warrants vigilance for respiratory failure and stroke; this observational association leaves open whether targeted interventions improve survival.
OBJECTIVES: Takotsubo cardiomyopathy (TC) is characterized by left-ventricle apical ballooning with elevated cardiac biomarkers and electrocardiographic changes similar to an acute coronary syndrome. We studied the prevalence, in-hospital mortality, and predictors of mortality in TC. METHODS: All patients ≥18 years of age diagnosed with TC were identified in the Nationwide Inpatient Sample (NIS) 2009-2010 database using the 9th revision of the International Classification of Diseases (ICD) 429.83. Demographics, conventional risk factors (diabetes, hypertension, hyperlipidemia, and tobacco abuse), acute critical illnesses like sepsis, acute cerebrovascular disease (cerebrovascular accident; CVA), acute respiratory insufficiency, and acute renal failure, and chronic conditions (anxiety, depression, and malignancy) were studied. RESULTS: The prevalence of TC was 0.02% (n = 7,510). The total in-hospital mortality rate was 2.4%, with a higher mortality in men (4.8%) than in women (2.1%). Sepsis (9 vs. 4.2%; p < 0.01) was more prevalent in men with an increased prevalence of other critical illness, although this was not statistically significant. Age (OR 1.05; 95% CI 1.01-1.09), malignancy (OR 3.38; 95% CI 1.35-8.41), acute renal failure (OR 5.4; 95% CI 2.2-13.7), acute CVA (OR 9.4; 95% CI 2.96-29.8), and acute respiratory failure (OR 11.1; 95% CI 3.9-31.1) predicted mortality in fully adjusted models. CONCLUSION: A higher mortality was seen in men, likely related to the increased prevalence of acute critical illnesses, ventricular arrhythmia, and sudden cardiac arrest. Acute CVA and respiratory failure were the strongest predictors of mortality.
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Krishnamoorthy et al. (2015) conducted an observational in Takotsubo cardiomyopathy (n=7,510). Male gender vs. Female gender was evaluated on In-hospital mortality. In patients with Takotsubo cardiomyopathy, in-hospital mortality was higher in men than women, while acute respiratory failure and acute CVA strongly predicted death.
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