Various Psychiatric Comorbidities and Smoking Appear to be Associated With Takotsubo Cardiomyopathy: A Nationwide Analysis From 2016 to 2022.

BACKGROUND

Takotsubo cardiomyopathy (TTC) is an acute heart condition in which physical or emotional stress causes left ventricular dysfunction. Psychiatric comorbidities have been linked to the precipitation of this condition, but large-scale data are limited. The goal of this study was to analyze the associations between TTC and various psychiatric conditions using nationally representative data.

METHODS

A retrospective observational cohort study was conducted using the Nationwide Inpatient Sample database from 2016 to 2022. International Classification of Diseases, Tenth Revision code I51.81 was used to identify hospitalized patients ≥18 years with a primary diagnosis of TTC. In addition, International Classification of Diseases, Tenth Revision codes were used to identify patients diagnosed with various psychiatric comorbidities.

RESULTS

A total of 291,600 patients had a primary diagnosis of TTC. The mean age was 67.1 ± 14.26 years, and 82.04% of the population was female. The following 4 psychiatric comorbidities were found to have significant associations with TTC: nicotine dependence [17.48% of patients; P < 0.001; odds ratio (OR), 1.08; 95% confidence intervals (CI), 1.06-1.11], depressive disorders (19.20% of patients; P < 0.001; OR, 1.46; 95% CI, 1.43-1.49), anxiety (24.25% of patients; P < 0.001; OR, 1.83; 95% CI, 1.80-1.87), and post traumatic stress disorder (2.91% of patients; P < 0.001; OR, 1.25; 95% CI, 1.18-1.31). No significant associations were found for dementia, alcohol related disorders, substance use other than tobacco and alcohol, manic disorders, or schizophrenia.

CONCLUSIONS

In this large, nationally representative sample, nicotine dependence, anxiety, depression, and post traumatic stress disorder were significantly associated with TTC. These findings highlight the importance of incorporating psychiatric health practices into the field of cardiology.