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

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.