Case Control Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Aug 26, 2021; 13(8): 340-347
Published online Aug 26, 2021. doi: 10.4330/wjc.v13.i8.340
Association of marital status with takotsubo syndrome (broken heart syndrome) among adults in the United States
Duke Appiah, Rachel Farias, Dena Helo, Linda Appiah, Olugbenga A Olokede, Chike C Nwabuo, Nandini Nair
Duke Appiah, Rachel Farias, Dena Helo, Olugbenga A Olokede, Department of Public Health, Texas Tech University Health Sciences Center, Lubbock, TX 79430, United States
Linda Appiah, College of Education, Texas Tech University, Lubbock, TX 79409, United States
Chike C Nwabuo, Division of Cardiology, Johns Hopkins University, Baltimore, MD 21218, United States
Nandini Nair, School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, United States
Author contributions: Appiah D, Nwabuo C, and Appiah L, conceived and performed conceptualization, analysis, and interpretation of data; Appiah D, Farias R, and Helo D wrote the manuscript; Farias R, Helo D, Appiah L, Olokede O, Nwabuo C, and Nair N reviewed and edited the manuscript, and provided expertise and feedback.
Institutional review board statement: All procedures of the National Hospital Discharge Survey were approved by the institutional review board of the National Center for Health Statistics. Because the National Hospital Discharge Survey data is deidentified and publicly available, the Texas Tech University Health Sciences Center Institutional Review Board determined that this current study did not require a review.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: All data are from the National Hospital Discharge Survey and are publicly available through the Centers for Disease Control and Prevention: https://www.cdc.gov/nchs/nhds/index.htm.
STROBE statement: The authors have read the STROBE Statement, and the manuscript was prepared and revised according to the STROBE Statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Duke Appiah, PhD, Assistant Professor, Department of Public Health, Texas Tech University Health Sciences Center, 3601 4th Street, STOP 9430, Lubbock, TX 79430, United States. duke.appiah@ttuhsc.edu
Received: February 24, 2021
Peer-review started: February 24, 2021
First decision: February 28, 2021
Revised: March 28, 2021
Accepted: July 27, 2021
Article in press: July 27, 2021
Published online: August 26, 2021
Processing time: 180 Days and 11.6 Hours
ARTICLE HIGHLIGHTS
Research background

The incidence of takotsubo syndrome (TTS) is increasing in the United States. However, the pathophysiology of TTS is not well understood, although, it is often precipitated by psychological or physical stress.

Research motivation

Marital status is related to emotional stress. However, not many studies have been conducted to evaluate the association of family relationships or social history with TTS.

Research objectives

The objective of this study was to evaluate the association of marital status namely being single, married, widowed or divorced/separated with TTS in an elderly population.

Research methods

A case-control study was performed using data on 649 patients from the United States National Hospital Discharge Survey.

Research results

Findings from this study showed that being married was associated with lower odds for TTS while being divorced/separated or widowed was associated with elevated odds for TTS.

Research conclusions

With marital status associated with TTS, understanding the underlying mechanisms for this association is of substantial clinical and public health importance.

Research perspectives

Confirmation of these observed associations from prospective studies are warranted to better understand the relation of marital status with TTS.