Department of Health Sciences, Houston Community College (Coleman), Houston, TX 77030, USA.
Independent Researcher, Atlanta, GA 30033, USA.
Med Sci (Basel). 2023 Sep 21;11(3):62. doi: 10.3390/medsci11030062.
The association of traditional cardiovascular disease (CVD) risk factors with outcomes of Takotsubo syndrome (TTS) is not well-defined. This study examined how modifiable CVD risk factors affect composite cardiovascular outcomes in TTS hospitalizations. TTS admissions were identified using ICD-10 codes and compared for demographics and comorbidities using the 2019 National Inpatient Sample. A multivariable regression examined the association of traditional CVD risk variables with adverse composite cardiovascular outcomes in TTS, controlling for confounders including sociodemographic or hospital-level characteristics and other relevant comorbidities. A total of 16,055 (38.1%) of the 41,855 adult TTS admissions had composite cardiovascular outcomes (TACCO). The TACCO cohort was 81.5% white, 77.3% female, and 72 years old. This group had higher rates of diabetes and peripheral vascular disease (PVD). The results showed that a higher prevalence of diabetes with chronic complications (OR = 1.18) and complicated hypertension (HTN) (OR = 1.1) predicted TACCO, whereas tobacco use disorder (OR = 0.84), hyperlipidemia (OR = 0.76), and uncomplicated HTN (OR = 0.65) ( < 0.001) showed a paradoxical effect with TACCO. TACCO had fewer routine discharges (35.3% vs. 63.4%), longer stays (6 vs. 3 days), and higher median hospital costs (78,309 USD vs. 44,966 USD). This population-based study found that complicated HTN and DM with chronic complications are strongly associated with adverse cardiovascular outcomes in TTS hospitalizations. But still, some risk factors, such as hyperlipidemia and uncomplicated HTN, have counterintuitive effects that require further evaluation. To prevent cardiac events in TTS patients, traditional CVD risk factors must be addressed.
传统心血管疾病 (CVD) 危险因素与 Takotsubo 综合征 (TTS) 结局的关系尚未明确。本研究旨在探讨可改变的 CVD 危险因素如何影响 TTS 住院患者的复合心血管结局。使用 ICD-10 编码识别 TTS 入院，并使用 2019 年国家住院样本比较人口统计学和合并症。多变量回归分析了传统 CVD 风险变量与 TTS 不良复合心血管结局的关系，控制了混杂因素，包括社会人口统计学或医院水平特征以及其他相关合并症。在 41855 例成人 TTS 入院中，共有 16055 例（38.1%）发生了复合心血管结局（TACCO）。TACCO 队列中 81.5%为白人，77.3%为女性，年龄为 72 岁。该组的糖尿病和外周血管疾病（PVD）发生率较高。结果显示，糖尿病伴慢性并发症（OR=1.18）和复杂高血压（HTN）（OR=1.1）的患病率较高预测了 TACCO，而烟草使用障碍（OR=0.84）、高脂血症（OR=0.76）和单纯 HTN（OR=0.65）（<0.001）与 TACCO 呈相反的关系。TACCO 常规出院率较低（35.3% vs. 63.4%），住院时间较长（6 天 vs. 3 天），中位住院费用较高（78309 美元 vs. 44966 美元）。这项基于人群的研究发现，复杂 HTN 和伴有慢性并发症的糖尿病与 TTS 住院患者的不良心血管结局密切相关。但是，一些风险因素，如高脂血症和单纯 HTN，具有反直觉的作用，需要进一步评估。为了预防 TTS 患者的心脏事件，必须解决传统的 CVD 危险因素。
