<p>The Impact of COPD on in-Hospital Outcomes in Patients with Takotsubo Cardiomyopathy</p>

Abstract

Chronic obstructive pulmonary disease (COPD) is a known comorbidity of takotsubo cardiomyopathy (TCM), and COPD exacerbation is a potential triggering factor of TCM. The association between COPD and in-hospital outcomes and complications among TCM patients is not well established. We sought to assess the effect of COPD on hospitalized patients with a primary diagnosis of TCM. Methods: We conducted a retrospective cohort study in patients with a primary diagnosis of TCM with or without COPD using the latest National Inpatient Sample from 2016-2017. We identified 3139 patients admitted with a primary diagnosis of TCM by the ICD-10-CM coding system; 684 of those patients also had a diagnosis of COPD. We performed propensity score matching in a 1:2 ratio (n=678 patients, matched COPD group; n=1070, matched non-COPD group) and compared in-hospital outcomes and complications between TCM patients with and without a COPD diagnosis. Results: Before matching, the COPD group had worse outcomes compared with the non-COPD group in inpatient death (2.9% vs 1.3%, p=0.006), length of stay (LOS) (4.02±2.99 days vs 3.27±3.39 days, p<0.001), hospitalization charges ($55,242.68±47,637.40 vs $48,316.97±47,939.84, p=0.001), and acute respiratory failure (ARF) (22.5% vs 7.7%, p<0.001), respectively. After propensity score matching, the matched COPD group, compared with the matched non-COPD group, had a higher inpatient mortality rate (2.9% vs1.0%, p=0.005), longer LOS (4.02±3.00 days vs 3.40±3.54 days, p<0.001), higher hospitalization charges ($55,409.23±47,809.13 vs $46,469.60±42,209.10, p<0.001), and a higher incidence of ARF (22.6% vs 8.2%, p<0.001) and cardiogenic shock (5.6% vs 3.3%, p=0.024), respectively. Conclusion: Patients with COPD who are hospitalized for TCM have higher rates of inpatient mortality, ARF, cardiogenic shock, as well as a longer LOS, and higher charges of stay than those without COPD. Prospective studies are warranted to examine the effect of early intervention or treatment of COPD on short-and long-term outcomes of TCM.

Prognostic factors of Takotsubo cardiomyopathy: a systematic review

“…The result was generated after patients were propensity-matched in a 1:2 target ratio (678 patients in the COPD-TCM group and 1070 in the non-COPD-TCM group) to avoid bias. 112 Another study of 14 639 TCM patients found that COPD was associated with greater in-hospital mortality (OR 1.444, 95% CI 1.140-1.829). 30 In addition, a study by Kato et al found that compared with those without lung disease, TCM patients with acute pulmonary triggers had greater 5 year mortality (HR 2.12, 95% CI 1.33-3.38), whereas chronic lung disease had no effect on mortality.…”

“…The result was generated after patients were propensity‐matched in a 1:2 target ratio (678 patients in the COPD‐TCM group and 1070 in the non‐COPD‐TCM group) to avoid bias. 112 Another study of 14 639 TCM patients found that COPD was associated with greater in‐hospital mortality (OR 1.444, 95% CI 1.140–1.829). 30 In addition, a study by Kato et al .…”

“…As a common cardiovascular risk factor, the prevalence of body mass index (BMI) > 30 kg/m 2 in TCM patients ranges from 8.5% to 12.7%. 36 , 111 , 112 However, the true association between BMI and TCM is still uncertain ( Table 5 ).…”

The Association Between Hyperlipidemia and In-Hospital Outcomes in Takotsubo Cardiomyopathy

“…The variables in our study include patient demographics (age, sex, race, household income, primary payer for the hospitalization) and hospital demographics (hospital type, hospital size and region). To further reduce selection bias, we included common cardiovascular comorbidities, such as smoking, hypertension, obstructive sleep apnea (OSA), peripheral artery disease (PAD), and other reported risk factors for TCM including chronic obstructive pulmonary disease (COPD), 21,22 anxiety 23 and depressive disorders, 18 obesity, 24 diabetes mellitus (DM), 25 chronic kidney disease (CKD) 26 and sepsis. 27 In-Hospital Outcomes…”

Anemia Is Associated With Poor Clinical Outcomes in Hospitalized Patients With Takotsubo Cardiomyopathy

“…9 In addition, previous studies revealed that many comorbidities could affect the outcomes of TCM, such as obesity, 10 hyperlipidemia, 11 diabetes mellitus (DM), 12 depressive disorders, 13,14 chronic kidney disease (CKD), 15 and chronic obstructive pulmonary disease (COPD). 14,16…”