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Impact of human immunodeficiency virus infection on Takotsubo cardiomyopathy outcomes in a large nationwide sample.

by Ali, Laith; Ghazzal, Amre; Radwan, Sohab; Desale, Sameer; Garcia-Garcia, Hector M.
Citation: Cardiovascular Revascularization Medicine. 2021 May 19.Journal: Cardiovascular revascularization medicine : including molecular interventions.Published: ; ; 2021ISSN: 1878-0938.Full author list: Ali L; Ghazzal A; Radwan S; Desale S; Garcia-Garcia HM.UI/PMID: 34049819.Subject(s): IN PROCESS -- NOT YET INDEXEDInstitution(s): MedStar Washington Hospital Center | MedStar Health Research Institute | MedStar Heart & Vascular InstituteDepartment(s): Internal Medicine ResidencyActivity type: Journal Article.Medline article type(s): Journal ArticleOnline resources: Click here to access online Digital Object Identifier: https://dx.doi.org/10.1016/j.carrev.2021.05.014 (Click here) Abbreviated citation: Cardiovasc Revasc Med. 2021 May 19.Local Holdings: Available in print through MWHC library: 2002 - present.Abstract: BACKGROUND/PURPOSE: Takotsubo Cardiomyopathy (TCM) or stress-induced cardiomyopathy is characterized by transient wall motion abnormalities often preceded by physical or emotional stress. Various baseline medical comorbidities were associated with worse outcomes theoretically due to their effect on chronic stress exposure. The effect of concurrent Human Immunodeficiency Virus (HIV) infection on outcomes of TCM has not been well established.Abstract: METHODS/MATERIAL: We conducted a US-wide analysis of TCM hospitalizations from 2006 to 2014 by querying the National Inpatient Sample database for the International Classification of Diseases-ninth Revision TCM code, baseline characteristics, and inpatient outcomes. TCM patients with HIV were compared to TCM patients without HIV. Multivariate regression models were constructed to account for potential confounders.Abstract: RESULTS: We identified 123,050 patients hospitalized with TCM, of those patients 304 had positive HIV status. In an unadjusted analysis, in-hospital outcomes were worse in TCM patients with HIV infection in terms of development of acute kidney injury (16.8% vs 33.3%, P-value 0.002), use of invasive mechanical ventilation (18.3% vs 34.5%, P-value 0.003), and mortality (5.3% vs 17.1%, P-value <0.0001). After adjusting for age, gender, and comorbidities there was no significant difference in the captured outcomes.Abstract: CONCLUSION: TCM patient with concurrent HIV had numerically worse outcomes. After adjusting for potential confounders, the statistical significance no longer existed. Suggesting that statistical difference was primarily driven by difference in baseline sociodemographic parameters and coexisting comorbidities. Copyright (c) 2021. Published by Elsevier Inc.

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