Prognostic value of CHA2DS2-VASc score for in-hospital outcomes in patients with Takotsubo syndrome

Carlos Diaz-Arocutipa*, Cesar Joel Benites-Moya, Samuel J. Apple, Saraschandra Vallabhajosyula

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: There is uncertainty about the use of the CHA2DS2-VASc score to predict clinical events in patients with Takotsubo syndrome (TTS). This study aimed to assess the short-term prognostic role of CHA2DS2-VASc score in this population. Methods: All admissions with a primary diagnosis of TTS were included using data from the National Inpatient Sample database during 2016–2019. The primary outcome was in-hospital mortality and secondary outcomes included ischemic stroke, intracardiac thrombus, cardiogenic shock, requirement for mechanical circulatory support, and renal replacement therapy. Patients were divided into 3 groups according to the CHA2DS2-VASc score. (0–3, 4–6, and >6). Logistic regression was used to estimate odds ratios (OR) with 95 % confidence intervals (CI). Results: A total 32,595 weighted hospitalizations were included (median age was 67 [58–76] years; 90 % female). The median CHA2DS2-VASc score value was 4 (2–5). In the adjusted models, in-hospital mortality was significantly higher in the CHA2DS2-VASc 4–6 (OR 1.86, 95 % CI 1.09–3.16, p = 0.022) and CHA2DS2-VASc >6 (OR 3.35, 95 % CI 1.60–7.04, p = 0.001) groups compared to the CHA2DS2-VASc 0–3 group. Likewise, the CHA2DS2-VASc >6 group had significantly higher odds of ischemic stroke (OR 2.92, 95 % CI 1.22–6.96, p = 0.016), intracardiac thrombus (OR 3.56, 95 % CI 1.36–9.30, p = 0.010), cardiogenic shock (OR 1.73, 95 % CI 1.05–2.86, =0.033), and renal replacement therapy (OR 2.87, 95 % CI 1.04–7.92, p = 0.042). Conclusions: Our results suggest that the CHA2DS2-VASc score is relatively useful for predicting in-hospital mortality and a range of clinical events in hospitalized patients with TTS.

Original languageEnglish
JournalCardiovascular Revascularization Medicine
DOIs
StateAccepted/In press - 2025

Keywords

  • Cardiac intensive care unit
  • Outcomes research
  • Takotsubo syndrome, CHA2DS2-VASc score, mortality

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