Usefulness of Malignancy as a Predictor of WorseIn-Hospital Outcomes in Patients With Takotsubo Cardiomyopathy.

MedStar author(s):
Citation: American Journal of Cardiology. 123(6):995-1001, 2019 03 15.PMID: 30595393Institution: MedStar Health Research Institute | MedStar Heart & Vascular InstituteDepartment: Medicine/Internal MedicineForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Hospitalization | *Neoplasms/ep [Epidemiology] | *Risk Assessment/mt [Methods] | *Takotsubo Cardiomyopathy/di [Diagnosis] | Aged | Coronary Angiography | Echocardiography | Electrocardiography | Female | Follow-Up Studies | Hospital Mortality/td [Trends] | Humans | Male | Neoplasms/co [Complications] | Prevalence | Prognosis | Retrospective Studies | Risk Factors | Survival Rate/td [Trends] | Takotsubo Cardiomyopathy/ep [Epidemiology] | Takotsubo Cardiomyopathy/et [Etiology] | United States/ep [Epidemiology]Year: 2019Local holdings: Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006ISSN:
  • 0002-9149
Name of journal: The American journal of cardiologyAbstract: Copyright (c) 2018. Published by Elsevier Inc.Takotsubo cardiomyopathy (TC) is a form of dilated cardiomyopathy often associated with physical or emotional stress. Association with cancer has been reported, however, in-hospital outcomes in TC patients with history of malignancy have not been fully characterized. We conducted a retrospective chart review of hospitalized patients with diagnosis of TC between January 2006 and January 2017. Patients were divided into 2 groups based on the previous history of malignancy. Presenting symptoms, cardiac imaging and short-term events including in-hospital complications and mortality, were compared. Of 318 patients with TC, 81 (25.4%) had a previous diagnosis of cancer. Mean age was 67.5 (SD 12.6), 151 (47.5%) were African American, 122 (38.4%) Caucasian, and 10 (3.1%) of other ethnicities. Patients with history of malignancy were older (70.0 [SD 10.6] vs 66.6 [SD 13.1] years, p=0.03), had higher heart rate on presentation (93 [SD 19] vs 87 [SD 25] beats/minute, p=0.03), higher prevalence of severely decreased cardiac function (left ventricular ejection fraction <25%) (29.6% vs 16%, p=0.01), longer hospitalization (7 (4-13) vs 4 (3-8) days, p=0.001) and experienced more in-hospital cardiac arrests (6 [7.4%] vs 5 [2.1%], p=0.035) compared with patients without malignancy history. Higher percentage of longer hospitalization and left ventricular ejection fraction <25% in the cancer group persisted after controlling for sepsis, chemotherapy exposure, and metastatic disease. In conclusion, in a racially diverse hospitalized population of TC, prevalence of cancer history is high, and diagnosis of previous malignancy is associated with adverse in- hospital outcomes.All authors: Al-Shbool G, Barac A, Basyal B, Campia U, Desale S, Kashyap K, Zaghlol ROriginally published: American Journal of Cardiology. 2018 Dec 22Fiscal year: FY2019Digital Object Identifier: Date added to catalog: 2019-01-18
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Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 30595393 Available 30595393

Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006

Copyright (c) 2018. Published by Elsevier Inc.

Takotsubo cardiomyopathy (TC) is a form of dilated cardiomyopathy often associated with physical or emotional stress. Association with cancer has been reported, however, in-hospital outcomes in TC patients with history of malignancy have not been fully characterized. We conducted a retrospective chart review of hospitalized patients with diagnosis of TC between January 2006 and January 2017. Patients were divided into 2 groups based on the previous history of malignancy. Presenting symptoms, cardiac imaging and short-term events including in-hospital complications and mortality, were compared. Of 318 patients with TC, 81 (25.4%) had a previous diagnosis of cancer. Mean age was 67.5 (SD 12.6), 151 (47.5%) were African American, 122 (38.4%) Caucasian, and 10 (3.1%) of other ethnicities. Patients with history of malignancy were older (70.0 [SD 10.6] vs 66.6 [SD 13.1] years, p=0.03), had higher heart rate on presentation (93 [SD 19] vs 87 [SD 25] beats/minute, p=0.03), higher prevalence of severely decreased cardiac function (left ventricular ejection fraction <25%) (29.6% vs 16%, p=0.01), longer hospitalization (7 (4-13) vs 4 (3-8) days, p=0.001) and experienced more in-hospital cardiac arrests (6 [7.4%] vs 5 [2.1%], p=0.035) compared with patients without malignancy history. Higher percentage of longer hospitalization and left ventricular ejection fraction <25% in the cancer group persisted after controlling for sepsis, chemotherapy exposure, and metastatic disease. In conclusion, in a racially diverse hospitalized population of TC, prevalence of cancer history is high, and diagnosis of previous malignancy is associated with adverse in- hospital outcomes.

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