Journal of Cancer Research and Clinical Oncology

, Volume 144, Issue 8, pp 1539–1545 | Cite as

Outcomes of Takotsubo cardiomyopathy in hospitalized cancer patients

  • Parijat Saurav Joy
  • Achuta Kumar GuddatiEmail author
  • Iuliana Shapira
Original Article – Clinical Oncology



Chemotherapy-induced cardiomyopathy is a critical complication of treatment for cancer. The emotional stress of a cancer diagnosis, ongoing chemotherapy, abnormal cancer-related wasting syndrome may contribute to cardiac morbidity in these patients. The burden of Takotsubo Cardiomyopathy (TCM) in cancer patients is unknown. The incidence of TCM and related outcomes in cancer patients was investigated in this study.


The 2007–2013 National Inpatient Sample (NIS) was analyzed for patients with a prior and new diagnosis of TCM with and without malignancy. Risk factors for mortality were adjusted for associated conditions by multivariable logistic regression analysis.


From 2007 to 2013, an estimated 122,855 adults were admitted with a diagnosis of TCM. In 2013, the incidence of admissions in US of patients with coexisting TCM and malignancy was 1.13%. Patients admitted for TCM with coexisting malignancy had a significantly higher mortality (13.8 vs. 2.9%, p < 0.0001), length of stay (7 vs. 4 days, p < 0.0001) and total charges ($29,291 vs. $36,231, p < 0.0001), compared to those with no malignancy. In patients with a primary diagnosis of TCM and without any underlying malignancy, males had a higher mortality (4.02 vs. 1.03%, p < 0.0001), whereas there was no gender difference in mortality in those with coexisting malignancy (6.25 vs. 6.45%, p = 0.965). On multivariable logistic regression analysis, risk factors associated with mortality were solid cancer (OR 3.43, p = 0.008), stroke (OR 18.33, p < 0.0001) and heart failure (OR 1.918, p = 0.004).


Outcomes are significantly worse in patients with TCM and malignancy. Hence, this patient population must be regarded as high-risk and early diagnostic consideration for TCM is warranted. Early intervention may help lower mortality, decrease resource utilization and reduce the health care costs in these patients.


Stress cardiomyopathy Cancer Outcomes Mortality 




Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interest.

Ethical approval

This is a retrospective study based on a publicly available database of the US government which uses de-identified patient data. This article does not contain any studies with human participants or animals performed by any of the authors.

Supplementary material

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Supplementary material 1 (DOCX 15 KB)
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Supplementary material 2 (DOCX 16 KB)
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Supplementary material 3 (DOCX 14 KB)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Parijat Saurav Joy
    • 1
  • Achuta Kumar Guddati
    • 2
    Email author
  • Iuliana Shapira
    • 3
  1. 1.Department of Internal MedicineUniversity of Iowa Hospitals and ClinicsIowa CityUSA
  2. 2.Division of Hematology/OncologyTulane UniversityNew OrleansUSA
  3. 3.Division of Hematology/OncologySUNY Downstate Medical CenterBrooklynUSA

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