Background:
Takotsubo cardiomyopathy (TCM) and inflammatory bowel disease (IBD) have both been linked to systemic inflammatory pathways, yet the clinical relationship between these conditions remains poorly understood. We evaluated the impact of concomitant IBD on outcomes among patients hospitalized with TCM using a nationally representative database.
Methods:
Hospitalizations for TCM were identified in the National Inpatient Sample (2016–2020) and stratified according to the presence or absence of IBD. The primary outcomes were in-hospital mortality and length of stay (LOS). Secondary outcomes were cardiogenic shock, cardiac arrest, acute kidney injury (AKI), acute pulmonary edema, left ventricular thrombus, cardiac tamponade, vasopressor utilization, central venous catheter placement, and mechanical circulatory support use, including Impella and extracorporeal membrane oxygenation (ECMO). Multivariable logistic regression was performed to determine adjusted associations.
Results:
Among 40,008 TCM hospitalizations, 504 (1.3%) had concomitant IBD. Patients with IBD were younger and had fewer traditional cardiovascular risk factors. LOS was significantly longer among patients with IBD (8.6 vs 6.9 days, p<0.001). Although in-hospital mortality was numerically higher, IBD was not independently associated with mortality (aOR 1.30, 95% CI 0.92–1.82; p=0.134). Concomitant IBD was independently associated with increased odds of AKI (aOR 1.37, p=0.003), ECMO utilization (aOR 4.21, p=0.006), central venous catheter placement (aOR 1.57, p=0.043), and cardiac tamponade (aOR 3.19, p=0.050). Vasopressor utilization and acute pulmonary edema demonstrated nonsignificant trends toward increased risk.
Conclusion:
Patients with concomitant IBD hospitalized with TCM represent a clinically distinct subgroup characterized by greater complications and resource utilization despite fewer traditional cardiovascular risk factors. These findings suggest that chronic inflammatory disease may influence the clinical severity and phenotype of TCM and warrants further investigation.
Keywords: Takotsubo cardiomyopathy; stress cardiomyopathy; inflammatory bowel disease; acute kidney injury; systemic inflammation
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