Racial and Sex Disparities in Patients With Takotsubo Cardiomyopathy With Inflammatory Bowel Disease

Takotsubo cardiomyopathy (TCM), a stress-induced cardiomyopathy, has been increasingly recognised, but its association with patients with inflammatory bowel disease (IBD) is not well established. This study aimed to assess the sex and racial differences in cardiovascular adverse events and outcomes in patients with TCM with IBD.

Using the National Inpatient Sample (2016-2021), we identified adult patients (aged ≥18 years) with IBD and TCM. Demographic, clinical characteristics, and adverse inpatient outcomes were compared in patients with TCM with and without IBD. Subgroup analyses were performed to assess sex and racial disparities in outcomes among patients with TCM and IBD.

Among 1,978,434 patients admitted to hospital with IBD, 3,225 (0.16%) had a concurrent diagnosis of TCM. The mean age was 64.8±13.6 years, with women comprising 83.9% of this cohort. Patients with IBD were less likely than those without IBD to have hypertension (57.6% vs 66.7%; p<0.001), diabetes (17.6% vs 24.4%; p<0.001), and hyperlipidaemia (34.1% vs 43.0%; p<0.001). IBD was linked to higher rates of venous thromboembolism (5.1% vs 3.4%; p=0.018), acute kidney injury (28.9% vs 23.8%; p=0.002), cardiogenic shock (8.8% vs 6.8%; p=0.042), extracorporeal membrane oxygenation (ECMO) use (0.6% vs 0.2%; p=0.03), and vasopressor support (6.2% vs 4.6%; p=0.048). Among patients with TCM-IBD, women were less likely to experience adverse events such as arrhythmias (odds ratio [OR] 0.51; 95% confidence interval [CI] 0.32-0.80; p=0.004). Black adults were more likely to require ECMO (OR 16.04; 95% CI 1.99-129.12; p=0.009).

IBD is associated with increased adverse outcomes in patients with TCM, with notable sex and racial disparities in complications.