Alcohol Use Disorder is Associated with an Increased Risk for Respiratory Failure among Patients with Takotsubo Cardiomyopathy

  • Temidayo Abe Internal Medicine Residency Program, Morehouse School of Medicine, Atlanta, Georgia 30310, United States
  • Valery Effoe Department of Cardiovascular Disease, Morehouse School of Medicine, Atlanta, Georgia 30310, United States
  • Dolphurs Hayes Department of Medicine, Morehouse School of Medicine, Atlanta, Georgia 30310, United States
  • Obiora Egbuche Department of Cardiovascular Disease, Morehouse School of Medicine, Atlanta, Georgia 30310, United States
  • Huynh Ky Department of Medicine, Morehouse School of Medicine, Atlanta, Georgia 30310, United States
  • Taiwo Ajose Internal Medicine Residency Program, Morehouse School of Medicine, Atlanta, Georgia 30310, United States
  • Adebanjo Olowu JHPIEGO, Plot 971 Reuben Okoye Crescent, Wuye, Abuja, Nigeria
Keywords: Takotsubo, Cardiomyopathy, Alcohol use disorder, Respiratory Failure

Abstract

BACKGROUND: While takotsubo cardiomyopathy (TCM) was initially considered a benign disease, recent studies have demonstrated poor cardiovascular outcomes. It is important to determine the predictors of these outcomes for appropriate risk stratification and to decrease the overall disease burden. Physical stressors (e.g., acute neurologic disorder and lung disorder) and pre-existing heart failure have been associated with worse outcomes. Alcohol abuse has been associated with cardiomyopathy and may also exacerbate pre-existing heart conditions.

AIM: We aimed to determine the impact of alcohol abuse on patients with TCM.

METHODS: We identified 11,221 patients from the 2009 to 2012 National Inpatient Sample, of which 10,622 had TCM alone and 599 had TCM and alcohol use disorder (AUD). Our outcomes of interest were overall mortality, need for mechanical hemodynamic support (MHS), acute respiratory failure, sudden cardiac arrest, cardiogenic shock, stroke, and atrial fibrillation. All clinical characteristics were defined per the International Classification of Diseases 9th revision codes. Logistic regression was used to estimate the odds ratios of the outcomes in patients with concomitant TCM and AUD, compared to those with TCM without AUD while adjusting for confounders.

RESULTS: The mean age of the sample was 60.5 ± 11 for TCM with AUD and 56.0 ± 11 for TCM alone. There was no significant difference between the two groups in the rates of atrial fibrillation (10.4% vs. 8,5%; p = 0.134), cardiogenic shock (5.9% vs. 4.8%; p = 0.3), use of MHS (2.6% vs. 1.7%; p = 0.165), overall in-hospital mortality (4.0% vs. 3.7%; p = 0.691), stroke (1.6% vs. 1.3%; p = 0.593), and sudden cardiac arrest (2.7% vs. 3.5%; p = 0.24). Rates of acute respiratory failure (17.7% vs. 25.2%; p < 0.0001) were significantly higher in patients with TCM with AUD compared to those with TCM alone. After adjusting for significant cofounders, the odds ratio for respiratory failure among patients with concomitant TCM and AUD was 1.36 (95% CI: 1.11–1.66) compared to those with TCM without AUD.

CONCLUSION: Pre-existing AUD is associated with an increased risk for respiratory failure in a patient with TCM.

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References

Y-Hassan S, Tornvall P. Epidemiology, pathogenesis, and management of takotsubo syndrome. Clin Auton Res. 2018;28(1):53-65. https://doi.org/10.1007/s10286-017-0465-z PMid:28917022

Lyon AR, Bossone E, Schneider B, Sechtem U, Citro R, Underwood SR, et al. Current state of knowledge on takotsubo syndrome: A position statement from the taskforce on takotsubo syndrome of the heart failure association of the European society of cardiology. Eur J Heart Fail. 2015;18(1):8-27. https:// doi.org/10.1002/ejhf.424 PMid:26548803

Ghadri JR, Wittstein IS, Prasad A, Sharkey S, Dote K, Akashi YJ, et al. International expert consensus document on takotsubo syndrome (Part I): Diagnostic workup, outcome, and management. Eur Heart J. 2018;39(22):2032-46. https://doi. org/10.1093/eurheartj/ehy077 PMid:29850871

Ghadri JR, Wittstein IS, Prasad A, Sharkey S, Dote K, Akashi YJ, et al. International expert consensus document on takotsubo syndrome (Part II): Diagnostic workup, outcome, and management. Eur Heart J. 2018;39(22):2047-62. https://doi. org/10.1093/eurheartj/ehy077 PMid:29850820

Steiner JL, Lang CH. Etiology of alcoholic cardiomyopathy: Mitochondria, oxidative stress and apoptosis. Int J Biochem Cell Biol. 2017;89:125-35. https://doi.org/10.1016/j. biocel.2017.06.009 PMid:28606389

Piano MR, Phillips SA. Alcoholic cardiomyopathy: Pathophysiologic insights. Cardiovasc Toxicol. 2014;14(4):291- 308. https://doi.org/10.1007/s12012-014-9252-4 PMid:24671642

Anand V, Roy SS, Archer SL, Weir EK, Garg SK, Duval S, et al. Trends and outcomes of pulmonary arterial hypertension-related hospitalizations in the United States: Analysis of the nationwide inpatient sample database from 2001 through 2012. JAMA Cardiol. 2016;1(9):1021-29. https://doi.org/10.1001/ jamacardio.2016.3591 PMid:27851838

Yassin AS, Subahi A, Adegbala O, Abubakar H, Dawdy J, Mishra T, et al. Clinical impact of atrial fibrillation on short-term outcomes and in-hospital mortality in patients with takotsubo syndrome: A propensity-matched national study. Cardiovasc Revasc Med. 2019;2019:S1553-8389. https://doi.org/10.1016/j. carrev.2019.07.022 PMid:31439442

Lemor A, Ramos-Rodriguez AJ, De La Villa R, Dehkordi SH, Lara FV, Lee S, et al. Impact of gender on in-hospital outcomes in patients with takotsubo syndrome: A nationwide analysis from 2006 to 2014. Clin Cardiol. 2019;42(1):13-8. https://doi. org/10.1002/clc.23109 PMid:30393886

Gupta S, Goyal P, Idrees S, Aggarwal S, Bajaj D, Mattana J. Association of endocrine conditions with takotsubo cardiomyopathy: A comprehensive review. J Am Heart Assoc. 2018;7(19):e009003. https://doi.org/10.1161/jaha.118.009003 PMid:30371307

Pelliccia F, Pasceri V, Patti G, Tanzilli G, Speciale G, Gaudio C, et al. Long-term prognosis and outcome predictors in takotsubo syndrome. A systematic review and meta-regression study. JACC Heart Fail. 2019;7(2):143-54. https://doi.org/10.1016/j. jchf.2018.10.009 PMid:30611720

Desai R, Singh S, Baikpour M, Goyal H, Dhoble A, Deshmukh A, et al. Does obesity affect the outcomes in takotsubo cardiomyopathy? Analysis of the nationwide inpatient sample database, 2010-2014. Clin Cardiol. 2018;41(8):1028-34. https:// doi.org/10.1002/clc.22999 PMid:29917260

Roshanzamir S, Showkathali R. Takotsubo cardiomyopathy a short review. Curr Cardiol Rev. 2013;9(3):191-6. https://doi. org/10.2174/1573403x11309030003 PMid:23642025

Molina PE, Gardner JD, Souza-Smith FM, Whitaker AM. Alcohol abuse: Critical pathophysiological processes and contribution to disease burden. Physiology (Bethesda). 2014;29(3):203-15. https://doi.org/10.1152/physiol.00055.2013 PMid:24789985

Moss M, Bucher B, Moore FA, Moore EE, Parsons PE. The role of chronic alcohol abuse in the development of acute respiratory distress syndrome in adults. JAMA. 1996;275(1):50-4. https:// doi.org/10.1001/jama.1996.03530250054027 PMid:8531287

Gupta NM, Lindenauer PK, Yu PC, Imrey PB, Haessler S, Deshpande A, et al. Association between alcohol use disorders and outcomes of patients hospitalized with community-acquired

Published
2020-06-06
How to Cite
1.
Abe T, Effoe V, Hayes D, Egbuche O, Ky H, Ajose T, Olowu A. Alcohol Use Disorder is Associated with an Increased Risk for Respiratory Failure among Patients with Takotsubo Cardiomyopathy. Open Access Maced J Med Sci [Internet]. 2020Jun.6 [cited 2020Oct.23];8(B):268-72. Available from: https://www.id-press.eu/mjms/article/view/4166