Abstract
Background
The effects of atrial fibrillation (AF) and its burden on in-hospital mortality in
patients with Takotsubo cardiomyopathy (TCM) are unclear. Here, we examined the effect
of AF and paroxysmal AF on in-hospital outcomes in patients with TCM.
Methods
We used ICD-10 codes to retrospectively identify patients with a primary diagnosis
of TCM in the National Inpatient Sample database 2016-2018. We compared in-hospital
outcomes in TCM patients with and without AF before and after propensity score matching.
The effect of AF burden on outcomes was assessed in patients with paroxysmal AF and
no AF.
Results
Of the 4,733 patients with a primary diagnosis of TCM, 650 (13.7%) had AF, and 4,083
(86.3%) did not. Of TCM patients with AF, 368 (56.6%) had paroxysmal AF. In-hospital
mortality was higher in patients with AF before (3.4% vs 1.2%, P < 0.001) and after propensity matching (3.4% vs 1.7%, P = 0.021) but did not differ between the paroxysmal AF and the no AF groups (P = 0.205). In the matched cohorts, both AF and paroxysmal AF groups were associated
with a higher rate of cardiogenic shock (AF, P < 0.001; paroxysmal AF, P < 0.001), ventricular arrhythmia (AF, P = 0.002; paroxysmal AF, P = 0.02), acute kidney injury (AF, P = 0.007; paroxysmal AF, P = 0.008), and acute respiratory failure (AF, P < 0.001; paroxysmal AF, P < 0.001) compared with the no AF group.
Conclusions
Although AF was associated with increased in-hospital mortality, paroxysmal AF did
not affect in-hospital mortality, suggesting a higher AF burden is associated with
worse clinical outcome in patients with TCM.
Key Indexing Terms
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Article info
Publication history
Published online: July 03, 2022
Accepted:
June 28,
2022
Received:
August 12,
2021
Identification
Copyright
© 2022 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.
