Sex‐ and Age‐Based Temporal Trends in Takotsubo Syndrome Incidence in the United States
2021; Wiley; Volume: 10; Issue: 20 Linguagem: Inglês
10.1161/jaha.120.019583
ISSN2047-9980
AutoresVarun Pattisapu, Hua Hao, Yunxian Liu, Trevor‐Trung Nguyen, Amy Hoang, C. Noel Bairey Merz, Susan Cheng,
Tópico(s)Cardiac Health and Mental Health
ResumoHomeJournal of the American Heart AssociationVol. 10, No. 20Sex‐ and Age‐Based Temporal Trends in Takotsubo Syndrome Incidence in the United States Open AccessLetterPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citations ShareShare onFacebookTwitterLinked InMendeleyRedditDiggEmail Jump toOpen AccessLetterPDF/EPUBSex‐ and Age‐Based Temporal Trends in Takotsubo Syndrome Incidence in the United States Varun K. Pattisapu, MD, Hua Hao, PhD, Yunxian Liu, PhD, Trevor‐Trung Nguyen, BS, Amy Hoang, MBS, C. Noel Bairey Merz, MD and Susan Cheng, MD, MPH Varun K. PattisapuVarun K. Pattisapu Barbra Streisand Women's Heart Center, , Smidt Heart Institute, Cedars‐Sinai Medical Center, , Los Angeles, , CA Search for more papers by this author , Hua HaoHua Hao https://orcid.org/0000-0001-5431-7984 University of Southern California Keck School of Medicine, , Los Angeles, , CA Search for more papers by this author , Yunxian LiuYunxian Liu https://orcid.org/0000-0002-3570-103X Department of Cardiology, , Smidt Heart Institute, Cedars‐Sinai Medical Center, , Los Angeles, , CA Search for more papers by this author , Trevor‐Trung NguyenTrevor‐Trung Nguyen Department of Cardiology, , Smidt Heart Institute, Cedars‐Sinai Medical Center, , Los Angeles, , CA Search for more papers by this author , Amy HoangAmy Hoang Department of Cardiology, , Smidt Heart Institute, Cedars‐Sinai Medical Center, , Los Angeles, , CA Search for more papers by this author , C. Noel Bairey MerzC. Noel Bairey Merz https://orcid.org/0000-0002-9933-5155 Barbra Streisand Women's Heart Center, , Smidt Heart Institute, Cedars‐Sinai Medical Center, , Los Angeles, , CA Department of Cardiology, , Smidt Heart Institute, Cedars‐Sinai Medical Center, , Los Angeles, , CA Search for more papers by this author and Susan ChengSusan Cheng * Correspondence to: Susan Cheng, MD, MPH, Department of Cardiology, Smidt Heart Institute, Cedars‐Sinai Medical Center, 127 San Vicente Blvd, Suite A‐3100, Los Angeles, CA 90048. E‐mail E-mail Address: [email protected] https://orcid.org/0000-0002-4977-036X Barbra Streisand Women's Heart Center, , Smidt Heart Institute, Cedars‐Sinai Medical Center, , Los Angeles, , CA Department of Cardiology, , Smidt Heart Institute, Cedars‐Sinai Medical Center, , Los Angeles, , CA Search for more papers by this author Originally published13 Oct 2021https://doi.org/10.1161/JAHA.120.019583Journal of the American Heart Association. 2021;10:e019583Other version(s) of this articleYou are viewing the most recent version of this article. Previous versions: October 13, 2021: Ahead of Print Takotsubo syndrome (TTS) is an uncommon but important cause of myocardial infarction that has been increasingly recognized in the United States.1, 2 The extent to which documented TTS incidence in the United States may have changed over time, across age groups as well as by sex, is not well understood.All data supporting the findings are publicly available through the National Inpatient Sample (NIS) database provided by the Healthcare Cost and Utilization Project.We investigated age‐ and sex‐based temporal trends in TTS incidence, using NIS3 data from years 2006 to 2017. We included patients aged ≥18 years with a primary or secondary TTS diagnosis (International Classification of Diseases, Ninth Revision, Clinical Modification [ICD‐9‐CM] code 429.83 or International Classification of Diseases, Tenth Revision, Clinical Modification [ICD‐10‐CM] code I51.81). We excluded those without coronary angiography or with coronary angiography and subsequent percutaneous coronary intervention. Per Healthcare Cost and Utilization Project analysis guidelines, we applied “trend weights” and estimated incidence (and SEs) using PROC SURVEYMEANS. We used generalized linear regression to test for differences in temporal trends across sex‐stratified age groups. All analyses were performed using SAS v9.4 and R v3.6.3. All study protocols were approved by the Cedars‐Sinai Institutional Review Board, with the requirement for individual informed consent waived.Over the total study period, we identified 135 463 documented cases of TTS. The annual incidence increased steadily in both sexes, with women contributing most cases (88.3%), especially those aged ≥50 years (Figure). In particular, we observed a significantly greater increase in TTS incidence among middle‐aged (128 cases per million per year) and older (96 cases per million per year) women compared with younger (15 cases per million per year) women (P<0.001). Increase in TTS incidence among middle‐aged (20 cases per million per year) men was also significant compared with younger (10 cases per million per year) men (P 135 000 cases documented over a span of almost 2 decades offered ample statistical power to detect not only increasing incidence of TTS in the United States, but a steep increase among especially middle‐aged to older women. This overall trend was disproportionate to that seen in other subgroups and appears not completely explained by improvements in clinical recognition. Future studies are needed to validate and extend from our results as part of efforts to clarify the susceptibility, pathophysiological features, and outcomes related to TTS for those individuals at the highest risk.Sources of FundingThis study was funded in part by National Institutes of Health grants R01‐HL134168, R01‐HL131532, R01‐HL143227, R01‐HL142983, R01‐HL146158, and U54‐AG065141; National Center for Advancing Translational Sciences grant UL1TR000124; and the Edythe L. Broad and the Constance Austin Women's Heart Research Fellowships, the Barbra Streisand Women's Cardiovascular Research and Education Program, the Linda Joy Pollin Women's Heart Health Program, the Erika J. Glazer Women's Heart Health Project, and the Adelson Family Foundation, Cedars‐Sinai Medical Center. The funding sponsors had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.DisclosuresDr Bairey Merz reports a grant from Sanofi ACT14656; personal fees from the Bayer Advisory Board, iRhythm, and Med Intelligence; and fees paid through Cedars‐Sinai Medical Center from Abbott Diagnostics and Sanofi, all outside of the submitted work. The remaining authors have no disclosures to report.Footnotes* Correspondence to: Susan Cheng, MD, MPH, Department of Cardiology, Smidt Heart Institute, Cedars‐Sinai Medical Center, 127 San Vicente Blvd, Suite A‐3100, Los Angeles, CA 90048. E‐mail susan.[email protected]org*V.K. Pattisapu and H. Hao contributed equally.For Sources of Funding and Disclosures, see page 3.REFERENCES1 Deshmukh A, Kumar G, Pant S, Rihal C, Murugiah K, Mehta JL. Prevalence of Takotsubo cardiomyopathy in the United States. Am Heart J. 2012; 164:66–71.e1. doi: 10.1016/j.ahj.2012.03.020CrossrefMedlineGoogle Scholar2 Khera R, Light‐McGroary K, Zahr F, Horwitz PA, Girotra S. Trends in hospitalization for Takotsubo cardiomyopathy in the United States. Am Heart J. 2016; 172:53–63. doi: 10.1016/j.ahj.2015.10.022CrossrefMedlineGoogle Scholar3 Khera R, Angraal S, Couch T, Welsh JW, Nallamothu BK, Girotra S, Chan PS, Krumholz HM. Adherence to methodological standards in research using the National Inpatient Sample. JAMA. 2017; 318:2011–2018. doi: 10.1001/jama.2017.17653CrossrefMedlineGoogle Scholar4 Templin C, Ghadri JR, Diekmann J, Napp LC, Bataiosu DR, Jaguszewski M, Cammann VL, Sarcon A, Geyer V, Neumann CA, et al. Clinical features and outcomes of Takotsubo (stress) cardiomyopathy. N Engl J Med. 2015; 373:929–938. doi: 10.1056/NEJMoa1406761CrossrefMedlineGoogle Scholar5 Pelliccia F, Kaski JC, Crea F, Camici PG. Pathophysiology of Takotsubo syndrome. Circulation. 2017; 135:2426–2441. doi: 10.1161/CIRCULATIONAHA.116.027121LinkGoogle Scholar Previous Back to top Next FiguresReferencesRelatedDetailsCited BySingh T, Khan H, Gamble D, Scally C, Newby D and Dawson D (2022) Takotsubo Syndrome: Pathophysiology, Emerging Concepts, and Clinical Implications, Circulation, 145:13, (1002-1019), Online publication date: 29-Mar-2022. October 19, 2021Vol 10, Issue 20Article InformationMetrics Copyright © 2021 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley BlackwellThis is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.https://doi.org/10.1161/JAHA.120.019583PMID: 34641717 Manuscript receivedSeptember 29, 2020Manuscript acceptedAugust 23, 2021Originally publishedOctober 13, 2021 KeywordsTakotsubo syndromesex differencesmyocardial infarctionage differencesPDF download SubjectsMyocardial Infarction
Referência(s)