MedStar Authors catalog › Details for: Usefulness of Malignancy as a Predictor of WorseIn-Hospital Outcomes in Patients With Takotsubo Cardiomyopathy.
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Usefulness of Malignancy as a Predictor of WorseIn-Hospital Outcomes in Patients With Takotsubo Cardiomyopathy.

by Al-Shbool, Ghassan; Barac, Ana; Basyal, Binaya; Desale, Sameer; Kashyap, Kartikeya-; Zaghlol, Raja.
Citation: American Journal of Cardiology. 123(6):995-1001, 2019 03 15.; .Journal: The American journal of cardiology.Published: 2019; ; ; ISSN: 0002-9149.Full author list: Al-Shbool G; Barac A; Basyal B; Campia U; Desale S; Kashyap K; Zaghlol R.UI/PMID: 30595393.Subject(s): *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]Institution(s): MedStar Health Research Institute | MedStar Heart & Vascular InstituteDepartment(s): Medicine/Internal MedicineActivity type: Journal Article.Medline article type(s): Journal ArticleDigital Object Identifier: (Click here) Abbreviated citation: Am J Cardiol. 123(6):995-1001, 2019 03 15; .Local Holdings: Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006.Abstract: Copyright (c) 2018. Published by Elsevier Inc.Abstract: 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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