Department of Internal Medicine, MedStar Washington Hospital Center, 110 Irving St NW, Washington, DC 20010, United States of America.
Iowa Heart Center, MercyOne North Iowa Medical Center, 1000 4th Street Southwest, Mason City, IA 50401, United States of America.
Cardiovasc Revasc Med. 2022 Jul;40:78-81. doi: 10.1016/j.carrev.2022.03.005. Epub 2022 Mar 14.
Takotsubo cardiomyopathy (TCM) is an acute left ventricular dysfunction, typically due to a neuro-cardiogenic mechanism. Although many stressors can precipitate TCM, the role of migraines in hospitalized TCM patients has not been studied. Our objective is to describe the in-hospital outcomes of TCM in patients with a concurrent diagnosis of migraines.
We conducted a US-wide analysis of TCM hospitalizations from 2013 to 2017 by querying the National Inpatient Sample database for the International Classification of Diseases, Ninth and 10th Revisions (ICD-9 and ICD-10). Patients admitted with a principal diagnosis of TCM with a history of migraines were identified using the ICD-10 codes. TCM patients with migraines were then compared to TCM patients without migraines regarding mortality and acute inpatient complications (intubation, cardiac arrest, heart failure exacerbation, acute kidney injury). A logistic regression model was constructed to account for potential confounders.
A total of 172,025 TCM patients were identified. Of those patients, 3610 suffered from migraines. TCM patients with a diagnosis of migraine were associated with a lower odds for mortality (OR: 0.388; [0.311-0.485]; p < 0.001) and acute complications (OR: 0.511 [0.471-0.554]; p < 0.001) compared to those without migraines. After adjusting for confounders, the adjusted odds ratio for mortality was 0.622; [0.495-0.782]; p < 0.001, and acute complications were 0.563 [0.519-0.611]; p < 0.001.
TCM patients with migraines were found to have a better outcome and mortality. They had significantly fewer complications (cardiac arrest, heart failure exacerbation, intubation, acute kidney injury).
应激性心肌病（Takotsubo 心肌病，TCM）是一种急性左心室功能障碍，通常由神经心源性机制引起。尽管许多应激源可引发 TCM，但偏头痛在住院 TCM 患者中的作用尚未得到研究。我们的目的是描述并发偏头痛的 TCM 住院患者的院内结局。
我们通过查询国家住院患者样本数据库（National Inpatient Sample database）中疾病国际分类，第九和第十修订版（International Classification of Diseases，Ninth and 10th Revisions，ICD-9 和 ICD-10），对 2013 年至 2017 年的 TCM 住院患者进行了一项美国范围内的分析。使用 ICD-10 代码识别出主要诊断为 TCM 且有偏头痛病史的患者。然后，将患有偏头痛的 TCM 患者与没有偏头痛的 TCM 患者在死亡率和急性住院并发症（插管、心脏骤停、心力衰竭恶化、急性肾损伤）方面进行比较。构建了一个逻辑回归模型以考虑潜在的混杂因素。
共确定了 172025 例 TCM 患者。其中 3610 例患有偏头痛。与没有偏头痛的患者相比，诊断为偏头痛的 TCM 患者的死亡率（比值比：0.388；95%置信区间：0.311-0.485；p < 0.001）和急性并发症（比值比：0.511；95%置信区间：0.471-0.554；p < 0.001）的可能性较低。在校正混杂因素后，死亡率的调整比值比为 0.622；95%置信区间：0.495-0.782；p < 0.001，急性并发症的调整比值比为 0.563；95%置信区间：0.519-0.611；p < 0.001。
患有偏头痛的 TCM 患者的预后和死亡率更好。他们的并发症（心脏骤停、心力衰竭恶化、插管、急性肾损伤）明显更少。
