Analysis of risk factors for Takotsubo cardiomyopathy in older patients using large-scale medical reimbursement data

Takotsubo cardiomyopathy (TTS) is triggered by mental or physical stress and accompanied by symptoms such as acute myocardial infarction. In previous studies, although several cardiovascular risk factors have been reported, specific risk factors other than these remain unclear, particularly in older populations. In this study, we investigated associations between TTS and other diseases in Japanese high-risk older people. In this matched case-control study, age and sex were used as matching factors from the health insurance database registered with DeSC Healthcare Inc. from April 2014 to October 2022; a designed conditional Lasso regression analysis was used as a variable selection method. The data were categorized into two groups: aged ≥ 70 years and aged 60 to 70 years. A total of 6,512 patients were evaluated. The conditional Lasso regression analysis revealed that among individuals aged ≥ 70 years, the respiratory category had the highest proportion among the 39 disease categories with odds ratios of 1.1 or higher (nine categories [23.1%]). Among individuals aged 60 to 70 years, no specific disease category accounted for a large proportion. Respiratory disease was the main risk factor for TTS among patients aged ≥ 70 years; however, it could not be identified among patients aged 60 to 70 years.