Affiliations

Advocate Masonic Medical Center

Abstract

Background/Significance:

Iron-deficiency anemia (IDA) commonly complicates cardiovascular disease, but its association with outcomes in stress cardiomyopathy (SC) is not well defined.

Purpose:

We examined whether IDA in SC is associated with higher in-hospital mortality and greater resource utilization.

Methods:

Using the National Inpatient Sample (2016–2022), we identified adult SC hospitalizations and stratified admissions by IDA status. Survey-weighted multivariable logistic regression evaluated the association of IDA with in-hospital mortality (primary outcome).Key secondary outcomes—cardiogenic shock (CS), mechanical circulatory support (MCS), acute kidney injury (AKI), vasopressor use, length of stay (LOS), and total hospital charges (THC)—adjusting for demographics, comorbidities, and hospital characteristics.

Results:

Among 199,920 SC hospitalizations, 53,530 (26.8%) had IDA. Compared with SC without IDA, SC with IDA had higher in-hospital mortality (9.6% vs 5.5%; aOR 1.14, 95% CI 1.03–1.28) and higher rates of CS (9.7% vs 5.4%; aOR 1.25, 95% CI 1.12–1.39), MCS (2.1% vs 1.0%; aOR 1.39, 95% CI 1.12–1.71), AKI (3.5% vs 1.8%; aOR 1.74, 95% CI 1.63–1.85), and vasopressor use (6.9% vs 3.0%; aOR 1.61, 95% CI 1.41–1.86). Resource utilization was substantially greater with IDA, with longer median LOS (11 vs 5 days) and higher median THC ($160,524 vs $80,501) (all p<0.001).

Conclusion:

In a contemporary national cohort of SC hospitalizations, IDA was independently associated with higher in-hospital mortality, greater hemodynamic decompensation, increased renal injury, and markedly higher resource utilization. IDA identifies a high-risk SC phenotype and supports prospective evaluation of targeted anemia/iron-deficiency management strategies in this population.

Presentation Notes

Presented at Scientific Day; May 20, 2026; Milwaukee, WI.

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May 20th, 12:00 AM

When Stress Cardiomyopathy Meets Iron Deficiency: A Retrospective Cohort Study

Background/Significance:

Iron-deficiency anemia (IDA) commonly complicates cardiovascular disease, but its association with outcomes in stress cardiomyopathy (SC) is not well defined.

Purpose:

We examined whether IDA in SC is associated with higher in-hospital mortality and greater resource utilization.

Methods:

Using the National Inpatient Sample (2016–2022), we identified adult SC hospitalizations and stratified admissions by IDA status. Survey-weighted multivariable logistic regression evaluated the association of IDA with in-hospital mortality (primary outcome).Key secondary outcomes—cardiogenic shock (CS), mechanical circulatory support (MCS), acute kidney injury (AKI), vasopressor use, length of stay (LOS), and total hospital charges (THC)—adjusting for demographics, comorbidities, and hospital characteristics.

Results:

Among 199,920 SC hospitalizations, 53,530 (26.8%) had IDA. Compared with SC without IDA, SC with IDA had higher in-hospital mortality (9.6% vs 5.5%; aOR 1.14, 95% CI 1.03–1.28) and higher rates of CS (9.7% vs 5.4%; aOR 1.25, 95% CI 1.12–1.39), MCS (2.1% vs 1.0%; aOR 1.39, 95% CI 1.12–1.71), AKI (3.5% vs 1.8%; aOR 1.74, 95% CI 1.63–1.85), and vasopressor use (6.9% vs 3.0%; aOR 1.61, 95% CI 1.41–1.86). Resource utilization was substantially greater with IDA, with longer median LOS (11 vs 5 days) and higher median THC ($160,524 vs $80,501) (all p<0.001).

Conclusion:

In a contemporary national cohort of SC hospitalizations, IDA was independently associated with higher in-hospital mortality, greater hemodynamic decompensation, increased renal injury, and markedly higher resource utilization. IDA identifies a high-risk SC phenotype and supports prospective evaluation of targeted anemia/iron-deficiency management strategies in this population.

 

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