Sympathomimetic Recreational Drugs And Takotsubo Cardiomyopathy (TTC); Analysis From National Inpatient Survey (NIS) 2012-2014 | 63286
Journal of Clinical & Experimental Cardiology
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Background: Sympathomimetic recreational drugs (cocaine, amphetamines) causes’ decreased uptake of catecholamine causing
sudden elevation in the levels of catecholamine (serotonin, epinephrine and norepinephrine). Takotsubo cardiomyopathy (TTC) is
caused by a sudden elevation in the serum catecholamine. Given the similarity in the pathophysiology of TTC and pharmacodynamics
of these drugs, it is unclear if TTC prevalence is different among this patient population.
Objective: Aim of this study is to investigate if the prevalence of TTC is higher among patient that uses sympathomimetic drugs
(cocaine, amphetamines) when compared to the general population.
Methods: Among all the patients in the National Inpatient Sample database 2012-2014 (N=14,533,997), we identified patients using
cocaine, amphetamine. Our outcome of interest was prevalence of TTC in this population. Logistic regression analysis was performed
to assess the association between these recreational drugs and TTC. Using multivariate regression model, we adjusted for known
confounders of cardiac morbidity and mortality; age, gender, race, insurance type, socioeconomic status, tobacco use, alcohol abuse,
hyperlipidemia, diabetes, hypertension, renal failure, prior history of coronary artery disease and myocardial infarction.
Results: Among our total sample, 0.95% (138,659) uses cocaine, 0.44% (63,773) uses amphetamine, 1.37% (1,98,504). TTC was
diagnosed in 0.08% (12,070). There was no statistically significant difference in the odds of TTC among patient that uses cocaine
(AOR 1.00 [0.78-1.26]) and amphetamine (1.00[0.71-1.42]). Overall, patients that were diagnosed with TTC were likely to be female
(AOR 5.32 [5.04-5.62]), white (AOR 1.56[1.47-10.54]), history of hypertension (AOR 1.20[1.14-125], hyperlipidemia (AOR 1.50[1.44-
1.57]), smoking (AOR 1.41[1.33-1.48]) and increasing odds trends with age (AOR 12.78[10.71-15.25]).
Conclusion: Despite the common pathway of catecholamine surge in TTC and sympathomimetic recreational drugs (cocaine
and amphetamine), the prevalence of TTC is same among patients who use cocaine or amphetamine and the general population.
However, female gender, white race, hypertension, hyperlipidemia, smoking and increasing age are risk factors for TTC.
Samson Alliu completed his Graduation at University of Alabama at Birmingham with an MPH in Epidemiology. He is currently pursuing his Residency in Internal Medicine at Maimonides Medical Center. His research interests are “Cardiovascular disease outcome research and risk factors”.