Abstract TP212: Stroke Risk Following Takotsubo Cardiomyopathy

• Published in: Stroke (1970) Vol. 50; no. Suppl_1
• Main Authors: Morris, Nicholas A, Adejumo, Oluwayemisi L, Desai, Masoom, Chen, Monica, Murthy, Santosh B, Kamel, Hooman, Merkler, Alexander E
• Format: Journal Article
• Language: English
• Published: 01.02.2019
• ISSN: 0039-2499; 1524-4628
• DOI: 10.1161/str.50.suppl_1.TP212

Abstract only Introduction: Takotsubo cardiomyopathy, also known as stress cardiomyopathy, is an increasingly recognized cause of left ventricular dysfunction after acute brain injury. Previously considered a benign disease, recent small, single-center case series suggest that Takotusubo cardiomyopathy may be a risk factor for ischemic stroke. The strength and temporal profile of this association remain uncertain. Methods: We performed a cohort-crossover study using administrative claims data on all emergency department visits and acute care hospitalizations from 2005-2015 in California New York, and Florida. We identified patients with Takotsubo cardiomyopathy using a previously validated International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code. We excluded patients with a prior or concomitant stroke diagnosis. We compared the risk of ischemic stroke in the first year after Takotsubo cardiomyopathy to the risk of ischemic stroke in the second year after. The absolute risk increase and odds ratio (OR) were calculated using McNemar’s test for matched data. Results: Among 5,283 patients with Takotsubo cardiomyopathy (mean age, 67 years; 92% female), we identified 49 ischemic strokes during the year after Takotsubo cardiomyopathy versus 19 ischemic strokes in the control period 2 years later. The risk of stroke was significantly higher in the year after Takotsubo cardiomyopathy (absolute increase, 0.6%; 95% CI, 0.2%-0.9%) (OR, 2.6; 95% CI, 1.5-4.6) as compared to the control period. Conclusion: We found a heightened risk of ischemic stroke in the year after a diagnosis of Takotsubo cardiomyopathy, although the absolute risk increase was small.