Title:Association Between Hypothyroidism and Takotsubo Cardiomyopathy: Analysis of Nationwide Inpatient Sample Database
Volume: 13
Issue: 3
Author(s): Dominika M. Zoltowska*, Yashwant Agrawal, Sandeep Patri, Sourabh Aggarwal, Chandra S. Reddy, Nishtha Sareen, Jagadeesh Kumar Kalavakunta and Vishal Gupta
Affiliation:
- Department of Internal Medicine, Western Michigan University Homer Stryker School of Medicine, 300 Portage Street, Kalamazoo, MI 49007,United States
Keywords:
Acute heart failure, female gender, hypothyroidism, Takotsubo cardiomyopathy, left ventricular, coronary artery
disease.
Abstract: Background: Takotsubo Cardiomyopathy (TC), also called transient left ventricular (LV)
ballooning syndrome, resembles myocardial infarction and is characterized by LV dysfunction in the
absence of coronary artery disease. Hypothesis described for TC has been an intense social stressor,
pheochromocytoma, thyrotoxicosis among others. We performed this study to analyze the association
of hypothyroidism with TC.
Methods: We queried the Nationwide Inpatient Sample which represents 20% of all the United States
hospital data for our study. We identified TC and hypothyroidism through their respective ICD9.
Codes for years 2006-2012. SAS 9.4 was used to perform a chi-square analysis to find any statistical
significance and p < 0.05 used to determine statistical significance. Significant differences were identified
using odds ratio (OR) estimates.
Results: A total of 19,713 cases with TC were identified of which 17,340 (87.96%) were females and
2,373 (12.04%) were males. 3,272 patients with TC had diagnosis of hypothyroidism. There is statistically
significant evidence of an association between TC and hypothyroidism (OR 2.21 (95% CI: 2.11-
2.31); p<0.0001).
There is evidence of increased statistical significance of females having TC 5.24 (95% CI: 4.96-5.53;
(p<0.0001)) compared to males, with an increased statistically significance of females with hypothyroidism
having TC, OR 6.65 (95% CI: 5.57-7.93; p< 0.001) compared to males.
Conclusion: There is an increased association of hypothyroidism, especially hypothyroidism for females
with TC.
