Comparing the in-hospital outcomes of patients with Takotsubo cardiomyopathy and chronic obstructive pulmonary disease

Chenlin Li; Pengyang Li; Xiaojia Lu; Yan Chen; Peng Cai; Catherine Teng; Jie Jing; Jingkun Zhang; Shiyan Jiang; Yue Liu; Jing Liang; Yanxuan Wang; Bin Wang

doi:10.1016/j.hrtlng.2024.11.008

Comparing the in-hospital outcomes of patients with Takotsubo cardiomyopathy and chronic obstructive pulmonary disease

Heart Lung. 2024 Nov 20:70:43-49. doi: 10.1016/j.hrtlng.2024.11.008. Online ahead of print.

Authors

Chenlin Li¹, Pengyang Li², Xiaojia Lu³, Yan Chen⁴, Peng Cai⁵, Catherine Teng⁶, Jie Jing⁷, Jingkun Zhang⁸, Shiyan Jiang³, Yue Liu³, Jing Liang⁹, Yanxuan Wang¹⁰, Bin Wang¹¹

Affiliations

¹ Department of Cardiology, Jieyang People's Hospital, Jieyang, Guangdong, China.
² Division of Cardiology, Pauley Heart Center, Virginia Commonwealth University, Richmond, VA, USA.
³ Department of Cardiology, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China.
⁴ Department of Rheumatology and Immunology, the First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China.
⁵ Department of Mathematical Sciences, Worcester Polytechnic Institute, Worcester, MA, USA.
⁶ Division of Cardiology, Department of Medicine, University of Texas San Antonio, San Antonio, TX, USA.
⁷ Jilin University, Changchun, Jilin, China.
⁸ Cardiovascular Research Institute, University of California San Francisco, CA, USA.
⁹ Human Anatomy Laboratory, School of Basic Medicine, Xinxiang Medical University, Henan, China.
¹⁰ Human Anatomy Laboratory, School of International Education, Xinxiang Medical University, Henan, China.
¹¹ Department of Cardiology, The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China; Clinical Research Center, the First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China. Electronic address: wangbin_pku@126.com.

PMID: 39571492
DOI: 10.1016/j.hrtlng.2024.11.008

Abstract

Background: Secondary Takotsubo syndrome (TTS) differs from primary TTS in terms of clinical characteristics, management, and prognosis. COPD exacerbation has been recognized as a physical trigger for TTS, but its prognostic implications for secondary TTS are poorly understood.

Objectives: The purpose of this study was to examine the effects of COPD on in-hospital outcomes in TTS patients.

Methods: Using data from the National Inpatient Sample, patients with a primary diagnosis of COPD and a secondary diagnosis of TTS were identified (COPD-TTS group). Patients with a primary diagnosis of TTS and comorbid COPD were selected as a control group (TTS-COPD group). Then, we compared the in-hospital mortality and the incidence of adverse events before and after propensity score matching.

Results: 603 patients were included in each of the TTS-COPD and COPD-TTS groups after matching. In both groups, the average age of included patients was about 68 years, and more than 85 percent of them were female. There were no statistically significant differences in the in-hospital mortality or the incident of cardiac arrest, ventricular arrhythmias, and AKI, between the two groups (All, p > 0.05). Patients with COPD-TTS had a higher rate of acute respiratory failure (ARF) (p < 0.001), a lower rate of cardiogenic shock (p = 0.001), and a longer length of hospital stay (LOS) (p < 0.001) compared to patients with TTS-COPD.

Conclusions: Patients with COPD-TTS had a higher rate of ARF and a longer LOS but a lower risk of cardiogenic shock compared to patients with TTS-COPD.

Keywords: Chronic obstructive pulmonary disease; In-hospital outcomes; Primary and secondary; Takotsubo syndrome.