{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T13:23:45Z","timestamp":1785763425883,"version":"3.56.0"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T00:00:00Z","timestamp":1766102400000},"content-version":"vor","delay-in-days":2111,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,3,9]],"date-time":"2020-03-09T00:00:00Z","timestamp":1583712000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Takotsubo cardiomyopathy (TC) is characterized by transient ventricular impairment, often preceded by emotional or physical stress. Racial differences affect the outcomes of several cardiovascular conditions; however, the effect of race on TC remains unknown. This investigation aims to assess the effect of race on in-hospital outcomes of TC in a large national sample.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>We conducted a US-wide analysis of TC hospitalizations from 2006 to 2014 by querying the National Inpatient Sample database for the International Classification of Diseases-ninth Revision TC code, characteristics, and inpatient outcomes. Patients with a primary diagnosis of acute coronary syndrome were excluded to reduce selection bias. Caucasians were compared with African Americans (AA) for differences in baseline characteristics and in-hospital outcomes. Multivariate regression models were created to adjust for potential confounders. Of 97 650 TC patients, 83 807 (86.9%) were women, 89 624 (91.8%) identified as Caucasians, and 8026 (8.2%) as AA. The annual number of TC hospitalizations increased significantly from 2006 to 2014 in both races (from 335 to 21 265 annual cases, P &amp;lt; 0.001). In-hospital mortality initially increased (1\u20132% in 2006 to 5\u20136% in 2009, P &amp;lt; 0.001) and subsequently remained relatively stable around 5\u20137% with no significant difference between races. In unadjusted analysis, AA had more cardiac arrests [304 (3.8%) vs. 2569 (2.9%), P = 0.04], invasive mechanical ventilation [1671 (20.8%) vs. 15 897 (17.7%), P = 0.002], tracheostomies [242 (3%) vs. 1600 (1.8%), P = 0.001], acute kidney injuries [1765 (22%) vs. 14 608 (16.3%), P &amp;lt; 0.0001], and longer hospital stays [4.5 (3.2\u20134.8) vs. 3.8 (3.7\u20133.9) days, P &amp;lt; 0.0001] compared with Caucasians. After the adjustment for differences in age, gender, comorbidities (using the enhanced Charlson comorbidity index), hospital location\/teaching status, and socio-economic factors, all differences were significantly attenuated or eliminated. Additionally, the adjusted risk was lower in AA compared with Caucasians, for cardiogenic shock [odds ratio (OR) 0.61 (0.47\u20130.78), P &amp;lt; 0.0001], mechanical ventilation [OR 0.8 (0.70\u20130.92), P = 0.002] and intraaortic balloon pump insertion [OR 0.63 (0.41\u20130.99), P = 0.04].<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our investigation is the first large US-wide analysis studying racial variations in TC outcomes. AA overall have more in-hospital complications; however, the differences are driven by racial disparities in demographics, comorbidities, and socio-economic factors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.12664","type":"journal-article","created":{"date-parts":[[2020,3,9]],"date-time":"2020-03-09T04:11:23Z","timestamp":1583727083000},"page":"1056-1063","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":42,"title":["Racial Differences in Takotsubo Cardiomyopathy Outcomes in a Large Nationwide Sample"],"prefix":"10.1093","volume":"7","author":[{"given":"Raja","family":"Zaghlol","sequence":"first","affiliation":[{"name":"Division of Internal Medicine, Georgetown University\/MedStar Washington Hospital Center , Washington, DC ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit K.","family":"Dey","sequence":"additional","affiliation":[{"name":"Section of Inflammation and Cardiometabolic Diseases, National Heart, Lung and Blood Institute , Bethesda, MD ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sameer","family":"Desale","sequence":"additional","affiliation":[{"name":"Biostatistics and Biomedical Informatics Department, MedStar Health Research Institute , Hyattsville, MD ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Barac","sequence":"additional","affiliation":[{"name":"MedStar Heart and Vascular Institute, MedStar Washington Hospital Center , 110 Irving Street, NW, Ste, 1218, Washington, DC ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,3,9]]},"reference":[{"key":"2026012115041764200_ehf212664-bib-0001","doi-asserted-by":"crossref","first-page":"929","DOI":"10.1056\/NEJMoa1406761","article-title":"Clinical features and outcomes of takotsubo (stress) cardiomyopathy","volume":"373","author":"Templin","year":"2015","journal-title":"N Engl J Med"},{"key":"2026012115041764200_ehf212664-bib-0002","doi-asserted-by":"crossref","first-page":"2032","DOI":"10.1093\/eurheartj\/ehy076","article-title":"International expert consensus document on takotsubo syndrome (Part I): clinical characteristics, diagnostic criteria, and pathophysiology","volume":"39","author":"Ghadri","year":"2018","journal-title":"Eur Heart J"},{"key":"2026012115041764200_ehf212664-bib-0003","doi-asserted-by":"crossref","first-page":"1028","DOI":"10.1002\/clc.22999","article-title":"Does obesity affect the outcomes in takotsubo cardiomyopathy? 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