Association of marital status with takotsubo syndrome (broken heart syndrome) among adults in the United States

Table 1 Characteristics of participants according to case-control status, National Hospital Discharge Survey 2006-2010

Characteristics	Cases (n = 59)	AMI controls (n = 295)	P value2	Non-CVD controls (n = 295)	P values3
Age, (mean ± SD, yr)1	69.7 (11.4)	(69.8 (11.1)	-	69.7 (11.3)	-
Sex, female1	89.8%	89.8%	-	89.8%	-
Race			0.009		0.021
White	88.1%	67.1%		70.5%
Black	5.1%	16.3%		14.6%
Other	6.8%	16.6%		14.9%
Current smoker	15.3%	8.5%	0.104	17.3%	0.701
Type of insurance			0.424		0.537
Medicaid	8.5%	5.8%		5.8%
Private	22.0%	29.2%		27.8%
Medicare	69.5%	65.1%		66.4%
Health condition
Obese	6.8%	8.8%	0.597	5.1%	0.593
Hypertension	42.4%	50.5%	0.241	52.5%	0.133
Dyslipidemia	20.3%	15.9%	0.404	27.1%	0.272
Diabetes	15.3%	16.3%	0.845	17.6%	0.660
COPD	27.1%	16.3%	0.051	22.0%	0.390
Neurological disorders	6.8%	13.2%	0.178	13.2%	0.173
Psychiatric disorders	3.4%	7.1%	0.295	5.1%	0.577
Marital status			0.375		0.583
Married	39.0%	45.1%		42.7%
Not married	61.0%	54.9%		57.3 %

¹These variables are among the characteristics by which cases were matched to controls.

²P values for comparison of characteristics between cases and AMI controls.

³P values for comparison of characteristics between cases and non-CVD controls. AMI: Acute myocardial infarction; CI: Confidence interval; COPD: Chronic obstructive pulmonary disease; CVD: Cardiovascular disease.

Table 2 Adjusted estimates for the association of marital status with takotsubo syndrome by acute myocardial infarction and non-cardiovascular disease controls, National Hospital Discharge Survey 2006-2010¹

Marital status	Cases (n = 59)	AMI controls (n = 295)	Non-CVD controls (n = 295)	Odds ratios (95%CI) for AMI controls	Odds ratios (95%CI) for non-CVD controls
Single	10	53	40	1	1
Married	23	133	126	0.69 (0.63-0.75)	0.86 (0.79-0.93)
Widowed	16	76	93	1.09 (1.01-1.19)	1.14 (1.05-1.23)
Separated/divorced	10	33	36	1.27 (1.16-1.39)	1.32 (1.21-1.45)
Married	23	133	126	1	1
Not married	36	162	169	1.66 (1.58-1.75)	1.40 (1.34-1.46)

¹Each case was matched to five controls based on age, sex, year of takotsubo cardiomyopathy diagnosis and bed size of hospital. Adjusted for age, sex, year of TTS diagnosis, bed size of hospital, race, type of health insurance, smoking status, obesity, hypertension, dyslipidemia, diabetes and chronic obstructive pulmonary disease. AMI: Acute myocardial infarction; CI: Confidence interval; CVD: Cardiovascular disease.

Table 3 Estimates from fully adjusted models for the association of marital status with takotsubo syndrome by acute myocardial infarction and non-cardiovascular disease controls, National Hospital Discharge Survey 2006-2010¹

Marital status	Cases (n = 59)	AMI controls (n = 295)	Non-CVD controls (n = 295)	Odds ratios (95%CI) for AMI controls	Odds ratios (95%CI) for non-CVD controls
Single	10	53	40	1	1
Married	23	133	126	0.62 (0.57-0.68)	0.86 (0.79-0.93)
Widowed	16	76	93	1.04 (0.96-1.14)	1.19 (1.10-1.28)
Separated/divorced	10	33	36	1.30 (1.18-1.43)	1.36 (1.25-1.49)
Married	23	133	126	1	1
Not married	36	162	169	1.80 (1.71-1.91)	1.44 (1.38-1.51)

¹Each case was matched to five controls based on age, sex, year of takotsubo cardiomyopathy diagnosis and bed size of hospital. Adjusted for age, sex, year of TTS diagnosis, bed size of hospital, race, type of health insurance, smoking status, obesity, hypertension, dyslipidemia, diabetes, chronic obstructive pulmonary disease, neurologic and psychiatric disorders. AMI: Acute myocardial infarction; CI: Confidence interval; CVD: Cardiovascular disease.