Takotsubo syndrome: Does "Diabetes Paradox" exist?

被引:12
|
作者
Ahuja, Keerat Rai [1 ]
Nazir, Salik [2 ]
Jain, Vardhmaan [1 ]
Isogai, Toshiaki [1 ]
Saad, Anas M. [1 ]
Verma, Beni R. [1 ]
Shekhar, Shashank [1 ]
Kumar, Ravi [3 ]
Eltahawy, Ehab A. [2 ]
Madias, John E. [4 ,5 ]
机构
[1] Cleveland Clin Fdn, Heart & Vasc Inst, Cleveland, OH USA
[2] Univ Toledo, Dept Cardiovasc Med, Toledo, OH USA
[3] Guthrie Robert Packer Hosp, Sayre, PA USA
[4] Icahn Sch Med Mt Sinai, New York, NY 10029 USA
[5] Elmhurst Hosp Ctr, Div Cardiol, New York, NY 11373 USA
来源
HEART & LUNG | 2021年 / 50卷 / 02期
关键词
Takotsubo syndrome; Diabetes; Mortality in takotsubo syndrome; HYPOGLYCEMIA UNAWARENESS; EPINEPHRINE SECRETION; CARDIOMYOPATHY; PREVALENCE; MORTALITY; MORBIDITY; MELLITUS; FEATURES; OUTCOMES;
D O I
10.1016/j.hrtlng.2021.01.005
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Previous small-scale studies have reported conflicting findings regarding the prevalence of diabetes mellitus (DM) and its association with outcomes in patients with takotsubo syndrome (TTS) Objective: We sought to assess the prevalence of DM and its association with outcomes in TTS patients. Methods: Nationwide inpatient sample (NIS) was queried to extract patient information from January 1, 2009 to September 30, 2015. Propensity score matching (PSM) was done to compare mortality and other in-hospital outcomes. Results: A total of 40,327 hospitalizations for TTS were included. The prevalence of DM in TTS was 19.3% vs 23.1% (p-value < 0.01) in patients without TTS in the NIS from 2009 to 2015. In the PSM cohort, there was no difference in in-hospital mortality (1.1% vs 1.4%; p = 0.76), stroke (1.2% vs 0.9%; p = 0.09), cardiogenic shock (3.7% vs 3.9%; p = 0.61), cardiac arrest (1.2% vs 1.2%; p = 0.94), ventricular arrhythmias (3.7% vs 3.3%; p = 0.23), circulatory support (2.1% vs 1.8%; p = 0.17), and invasive mechanical ventilation (4.9% vs 4.7%; p = 0.54) in TTS patients with versus without diabetes. In sub-group analysis, diabetes with chronic complications patients were found to have lower mortality (0.7% vs 2.0%; p = 0.04) compared to patients without diabetes and those with uncomplicated diabetes (0.6% vs 2.6%; p = 0.002). Conclusions: Prevalence of DM was lower in TTS in comparison to patients without TTS. In addition, complicated DM patients were found to have lower in-hospital mortality. Further studies are needed to assess the mid and long-term outcomes of DM with and without chronic complications in TTS (C) 2021 Elsevier Inc. All rights reserved.
引用
收藏
页码:316 / 322
页数:7
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