Clinical Impact of Atrial Fibrillation on Short-Term Outcomes and In-Hospital Mortality in Patients with Takotsubo Syndrome: A Propensity-Matched National Study |
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| Affiliation: | 1. Department of Internal Medicine, Wayne State University School of Medicine/Detroit Medical Center, Detroit, MI, USA;2. Department of Internal Medicine, Englewood Hospital and Medical Center, Seton Hall University-Hackensack Meridian School of Medicine, Englewood, NJ, USA;3. Division of Cardiology, Department of Internal Medicine, Iowa University Hospital, Iowa, USA;4. Department of Internal Medicine, Beaumont Hospital, Dearborn, MI, USA;5. Faculty of Medicine, University of Khartoum, Khartoum, Sudan;6. Division of Cardiology, Department of Internal Medicine, Detroit Medical Center/Wayne State University School of Medicine, Detroit, MI, USA;1. Department of Internal Medicine, Jackson Memorial Hospital/University of Miami, Miami, Florida;2. Division of Cardiovascular Disease, University of Miami Miller School of Medicine, Miami, Florida;3. Division of Cardiovascular Disease, Jackson Memorial Hospital, Miami, Florida;1. Servicio de Cardiología, Hospital General Universitario Gregorio Marañón, CIBERCV, Madrid, Spain;2. Instituto Cardiovascular, Hospital Clínico San Carlos, Madrid, Spain;3. Servicio de Cardiología, Hospital de Manacor, Baleares, Spain;4. Complejo Hospitalario de Navarra, Navarra, Spain;5. Hospital de Sant Pau, Barcelona, Spain;6. Hospital Universitario de Salamanca, Salamanca, Spain;7. Complejo Hospitalario de Albacete, Albacete, Spain;8. Hospital Joan XXIII, Tarragona, Spain;9. Universidad Europea, Universidad Complutense, Madrid, Spain |
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| Abstract: | IntroductionTakotsubo Syndrome (TS) patients are at high risk of developing atrial fibrillation. We sought to investigate the outcomes and economic impact of atrial fibrillation on TS patients utilizing the National Inpatient Sample.MethodsPatients with TS were identified in the National Inpatient Sample (NIS) database between 2010 and 2014 using the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM), and subsequently were divided into two groups, those with and without atrial fibrillation. The primary outcome was all-cause in-hospital mortality in the two groups. Secondary outcomes were in-hospital complications. We also evaluated the length of hospital stay and the cost of hospitalization. Propensity score-matched analysis was performed to address potential confounding factors.ResultsAmong the study population, the prevalence of atrial fibrillation was 17.57%. After matching, the atrial fibrillation group had no significant increase of in-hospital mortality (OR: 1.13; 95% CI: 0.94–1.35, p = 0.211). However, atrial fibrillation patients were more likely to develop cardiac arrest and ventricular arrhythmias (OR: 1.51, 95% CI: 1.26–1.80, p < 0.0001), have higher rate of major cardiac complications when combined as a single endpoint in-hospital complication (OR: 1.16, 95% CI: 1.04–1.29, p: 0.006), also they were more likely to stay longer in hospital (OR: 1.13, 95% CI: 1.08–1.19, p < 0.0001), and have increased cost of hospitalization (OR: 1.13, 95% CI 1.07–1.20, p < 0.0001).ConclusionAtrial fibrillation does not increase in-hospital mortality in patients presenting with TS. However atrial fibrillation is associated with an increased risk of ventricular arrhythmias, length of stay, non-routine discharges and cost of hospitalization. |
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