Pre-existing Psychiatric Illness is Associated With Increased Risk of Recurrent Takotsubo Cardiomyopathy

Arash Nayeri, Eric Rafla-Yuan, Eric Farber-Eger, Marcia Blair, Boback Ziaeian, Martin Cadeiras, John A. McPherson, Quinn S. Wells

Research output: Contribution to journalArticlepeer-review

27 Scopus citations


Background The increased prevalence of psychiatric illness among patients with takotsubo cardiomyopathy (TC) has been previously described. Objectives We sought to assess the effect of pre-existing psychiatric illness on clinical outcomes following the diagnosis of TC. Methods Adults diagnosed with TC at Vanderbilt University Medical Center between 1999 and 2015 were included in the study. Medical records were retrospectively reviewed to identify any pre-existing mood, anxiety, or schizophrenia-spectrum illness before TC presentation. Multivariable logistic regression was used to test for independent association of pre-existing psychiatric illness with 30-day mortality and recurrent TC; Cox proportional hazard analysis was used to evaluate for association with long-term mortality. Results Among 306 patients diagnosed with TC during the study period, 114 (37%) had a pre-existing psychiatric illness. In all, 43 (14%) and 88 (29%) patients died within 30 days of index diagnosis and as of last medical record review, respectively. Of the 269 who survived their index hospitalization, 19 (7%) had a confirmed recurrent episode of TC. In multivariable analyses, pre-existing psychiatric illness was not associated with increased 30-day (P = 0.320) or long-term (P = 0.621) mortality. Pre-existing psychiatric illness was associated with higher risk of recurrent TC (odds ratio = 7.44, 95% CI: 2.30–24.01, P < 0.001). Conclusions Pre-existing psychiatric illness was associated with an increased risk of recurrent TC. No significant association was noted between pre-existing psychiatric illness and survival.

Original languageEnglish (US)
Pages (from-to)527-532
Number of pages6
Issue number5
StatePublished - Sep 2017


  • Psychiatric illness
  • Recurrence
  • Stress cardiomyopathy
  • Survival
  • Takotsubo

ASJC Scopus subject areas

  • Arts and Humanities (miscellaneous)
  • Applied Psychology
  • Psychiatry and Mental health


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