| アブストラクト | BACKGROUND: Although Takotsubo cardiomyopathy (TC) generally occurs after a stressful event out-of-hospital, it occasionally occurs secondary to acute medical illness after hospital admission. No study has examined and compared patient backgrounds and in-hospital outcomes between patients with out-of-hospital TC and those with in-hospital TC. METHODS AND RESULTS: Using the Diagnosis Procedure Combination inpatient database in Japan, we identified 3719 eligible patients with a diagnosis of TC who underwent coronary angiography without any revascularization procedure between 2010 and 2013, including 419 patients with in-hospital TC and 3300 patients with out-of-hospital TC. There was no significant difference in age between those with in-hospital TC and those with out-of-hospital TC (74.2 +/- 10.9 years versus 73.4 +/- 11.3 years, p=0.211). Patients with in-hospital TC had a higher proportion of males than out-of-hospital TC patients (31.3% versus 21.3%, p<0.001). Patients with in-hospital TC had significantly higher proportions of several chronic comorbidities and acute medical illnesses. In-hospital mortality was significantly higher in patients with in-hospital TC than in patients with out-of-hospital TC (17.9% versus 5.4%, p<0.001). In the multivariable logistic regression analysis, in-hospital TC was significantly associated with higher in-hospital mortality (adjusted odds ratio 2.02; 95% confidence interval, 1.43 to 2.85; p<0.001), even after adjustment for patient backgrounds. Malignancy, chronic liver disease, rheumatic disease, sepsis, pneumonia, cerebrovascular diseases, acute renal failure, and acute gastrointestinal diseases were also significantly associated with higher in-hospital mortality. CONCLUSIONS: In-hospital TC was associated with more severe clinical background and poorer short-term prognosis than out-of-hospital TC. |
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| ジャーナル名 | International journal of cardiology |
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| 投稿日 | 2014/08/15 |
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| 投稿者 | Isogai, Toshiaki; Yasunaga, Hideo; Matsui, Hiroki; Tanaka, Hiroyuki; Ueda, Tetsuro; Horiguchi, Hiromasa; Fushimi, Kiyohide |
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| 組織名 | Department of Clinical Epidemiology and Health Economics, School of Public;Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan;;Department of Cardiology, Tokyo Metropolitan Tama Medical Center, 2-8-29;Musashidai, Fuchu, Tokyo 183-8524, Japan. Electronic address:;toisogai-circ@umin.ac.jp.;Health, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.;Electronic address: yasunagah-tky@umin.ac.jp.;Electronic address: ptmatsui-tky@umin.ac.jp.;hiroyuki_tanaka@tmhp.jp.;tetsurou_ueda@tmhp.jp.;Department of Clinical Data Management and Research, Clinical Research Center,;National Hospital Organization Headquarters, 2-5-21 Higashigaoka, Meguro-ku,;Tokyo 152-0021, Japan. Electronic address: hiromasa-tky@umin.ac.jp.;Department of Health Policy and Informatics, Tokyo Medical and Dental University;Graduate School of Medicine, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan.;Electronic address: kfushimi.hci@tmd.ac.jp. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/25115252/ |
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