Takotsubo Syndrome in Black Americans: Insights From the National Inpatient Sample

Abstract

Background Data on race-related differences in the clinical outcomes of Takotsubo syndrome are limited, particularly for Black patients. This study aimed to assess whether race and sex may have an additional impact on the inpatient mortality of patients with Takotsubo syndrome. Methods A total of 4,628 patients from the United States' National Inpatient Sample from 2012 to 2016 were identified; propensity score analysis revealed a similar propensity score between Black patients (n = 2,314) and White patients (n = 2,314), which was used to balance observed covariates. Sex and age distributions were identical between the 2 groups. The groups were also similar in baseline characteristics, including cardiovascular risk factors. White patients were compared with Black patients on in-hospital outcomes and inpatient mortality. A logistic regression analysis was conducted to measure the difference in mortality based on race and sex. Results Compared with White patients, Black patients had a higher percentage of in-hospital complications, including cerebrovascular accidents (4.9% vs 2.5%, P ≤ .01), acute kidney injury (25% vs 19%, P ≤ .01); longer lengths of stay (8 vs 7 days, P ≤ .01); and higher inpatient mortality (6.1% vs 4.5%, P < .01). When analysis was conducted with race and sex combined, inpatient mortality was higher among Black men than among White women (odds ratio, 2.7 [95% CI, 1.80-3.95]; P ≤ .01). Conclusion This study showed that Black patients with Takotsubo syndrome have higher in-hospital complications and inpatient mortality rates. When race and sex were combined, inpatient mortality was significantly higher among Black men than among either White men and women or Black women.

Ventricular Tachycardia in Patients With Takotsubo Cardiomyopathy: Prevalence, Predictors, and Associated In-Hospital Adverse Events

“…This is consistent with the current literature that showed Black patients with TCM had higher rates of in-hospital adverse events and mortality [17]. The same study also found that inpatient mortality was higher for male patients who identified as Black than among females who identified as White [17]. While our study did not conduct an analysis on race and sex combined, on the basis of sex alone, our data found that females with TCM had lower mortality compared to males.…”

“…On the basis of demographics, our data showed that TCM patients who identified as Asian, Pacific Islander, or Black were at higher odds of mortality. This is consistent with the current literature that showed Black patients with TCM had higher rates of in-hospital adverse events and mortality [17]. The same study also found that inpatient mortality was higher for male patients who identified as Black than among females who identified as White [17].…”

Racial and Ethnic Disparities among Takotsubo Syndrome; A Nation-Wide Analysis

“…In summary, it was noted that the Black population had more adverse outcomes compared to other races, which is consistent with literature 14 . The heightened presence of comorbidities among Black individuals may be elucidated by the disparities in the labor market and employment 15,16, which inadvertently expose them to more physically strenuous and hazardous occupations.…”

“…In summary, it was noted that the Black population had more adverse outcomes compared to other races, which is consistent with literature 15 .…”

Cardiovascular Disease and Inpatient Complications in Turner Syndrome: A Propensity Score Analysis

“…This approach aimed to create matched cohorts with similar propensity scores between women with Turner syndrome and women without Turner syndrome. 18 , 19 …”