Table 5.
Clinical studies on the effects of comorbidities in TCM patients
| Comorbidities | Author (year) | Diagnostic criteria | Sample size | Type of study | Follow‐up | Mortality | Analysis strategy | Risk of bias |
|---|---|---|---|---|---|---|---|---|
| DM | DM vs. Non‐DM | |||||||
| Krishnamoorthy et al. (2015) | ICD‐9 | 7510 | Retrospective | In‐hospital | No difference | Multivariable logistic regression | High | |
| Khera et al. (2016) | ICD‐9 | 11 193 | Retrospective | In‐hospital | No difference | Multivariable logistic regression | High | |
| Stiermaier et al. (2016) | Mayo criteria | 286 | Prospective | Mean = 3.8 ± 2.5 years | HR 2.11 (95% CI 1.23–3.65), P < 0.01 | Multivariate Cox regression | Moderate | |
| Parodi et al. (2017) | In‐TAK criteria | 371 | Prospective | Mean = 26 ± 20 months | HR 2.86 (95% CI 1.29–6.35), P = 0.01 | Multivariate Cox regression | Moderate | |
| Almendro‐Delia et al. (2018) | Modified Mayo criteria | 711 | Prospective | Median = 284 days | HR 2.68 (95% CI 1.55–4.60), P < 0.0001 | Multivariate Cox regression | Moderate | |
| Ghadri et al. (2018) | Modified Mayo criteria | 1613 | Prospective | 5 years | No difference | Multivariable Cox regression | Moderate | |
| Stiermaier et al. (2018) | Mayo criteria and ESC criteria (2016) | 826 | Prospective | Median = 2.5 years | HR 1.66 (95% CI 1.16–2.39), P = 0.006 | Multivariate Cox regression | Moderate | |
| Uribarri et al. (2019) | Modified Mayo criteria | 939 | Prospective | 5 years | HR 2.750 (95% CI 1.758–4.302), P < 0.001 | Multivariable Cox regression | Moderate | |
| Yerasi et al. (2019) | ICD‐9 | 12 255 | Retrospective | In‐hospital | No difference | Multivariate regression | High | |
| Núñez‐Gil et al. (2020) | Modified Mayo criteria | 1097 | Prospective | Median = 27.5 months | HR 2.17 (95% CI 1.41–3.34), P < 0.001 | Multivariate Cox regression | Moderate | |
| Scudiero et al. (2020) | In‐TAK criteria | 561 | Prospective | Median = 29 months | HR 2.90 (95% CI 1.53–5.40), P = 0.001 | Multivariate Cox regression | Moderate | |
| Stiermaier et al. (2020) | Mayo criteria and ESC criteria (2016) | 147 | Prospective | 3 years | HR 6.15 (95% CI 2.18–17.32), P = 0.001 | Multivariable Cox regression | Moderate | |
| CKD | CKD vs. Non‐CKD | |||||||
| Isogai et al. (2014) | ICD‐10 | 3719 | Retrospective | In‐hospital | No difference | Multivariable logistic regression | High | |
| Khera et al. (2016) | ICD‐9 | 11 193 | Retrospective | In‐hospital | No difference | Multivariable logistic regression | High | |
| Weidner et al. (2017) | Mayo criteria | 114 | Prospective | 5 years | HR 3.1 (95% CI 1.4–7.0), P < 0.01 | Multivariate Cox regression | Moderate | |
| El‐Battrawy et al. (2017) | Mayo criteria | 114 | Prospective | Mean = 1529 ± 1121 days | HR 3.5 (95% CI 1.0–11.0), P = 0.03 | Multivariate Cox regression | Moderate | |
| Huseynov et al. (2017) | Mayo criteria | 114 | Prospective | Mean = 1591 ± 1079 days | HR 3.1 (95% CI 1.4–7.0), P < 0.01 | Multivariate Cox regression | Moderate | |
| El‐Battrawy et al. (2018) | Mayo criteria | 114 | Prospective | Mean = 3 years | HR 3.84 (95% CI 1.3–11.2), P = 0.01 | Multivariate Cox regression | Moderate | |
| Giannakopoulos et al. (2019) | Mayo criteria | 138 | Prospective | 5 years | HR 2.8 (95% CI 1.2–6.0), P = 0.01 | Multivariate Cox regression | Moderate | |
| Gietzen et al. (2019) | Mayo criteria | 138 | Prospective | 5 years | HR 2.8 (95% CI 1.2–6.0), P = 0.01 | Multivariate Cox regression | Moderate | |
| Yassin et al. (2019) | ICD‐9 | 2959 | Retrospective | In‐hospital | No difference | Multivariable logistic regression | High | |
| Syed et al. (2020) | ICD‐9 and ICD‐10 | 260 144 | Retrospective | In‐hospital | OR 1.2 (95% CI 1.16–1.30), P < 0.01 | Stepwise logistic regression | High | |
| Zalewska‐Adamiec et al. (2020) | Mayo criteria | 101 | Prospective | Mean = 7.2 years | OR 0.954 (95% CI 0.920–0.989), P = 0.01 | Multivariable logistic regression | Moderate | |
| Napierkowski et al. (2021) | ICD‐9 | 14 639 | Retrospective | In‐hospital | OR 1.756 (95% CI 1.266–2.436), P = 0.001 | Multivariable logistic regression | High | |
| Cancer | Cancer vs. Non‐cancer | |||||||
| Isogai et al. (2014) | ICD‐10 | 3719 | Retrospective | In‐hospital | OR 3.23 (95% CI 2.21–4.72), P < 0.001 | Multivariable logistic regression | High | |
| Krishnamoorthy et al. (2015) | ICD‐9 | 7510 | Retrospective | In‐hospital | OR 3.38 (95% CI 1.35–8.41), P < 0.01 | Multivariable logistic regression | High | |
| Lee et al. (2016) | Mayo criteria | 128 | Retrospective | In‐hospital | No difference | Multivariable logistic regression | Moderate | |
| Girardey et al. (2016) | Madias criteria | 154 | Prospective | Median = 364 days |
Cardiac mortality: HR 4.77 (95% CI 1.02–22.17), P = 0.046 All‐cause mortality: HR 2.62 (95% CI 1.26–5.44), P = 0.01 |
Multivariable Cox regression | Moderate | |
| Khera et al. (2016) | ICD‐9 | 11 193 | Retrospective | In‐hospital | No difference | Multivariable logistic regression | High | |
| Bill et al. (2017) | Mayo criteria | 114 | Prospective | 2 years | HR 2.76 (95% CI 0.8–9.0), P = 0.09 | Multivariate Cox regression | Moderate | |
| Almendro‐Delia et al. (2018) | Modified Mayo criteria | 711 | Prospective | Median = 284 days | HR 2.38 (95% CI 1.18–4.81), P = 0.016 | Multivariate Cox regression | Moderate | |
| El‐Battrawy et al. (2018) | Mayo criteria | 114 | Prospective | Mean = 3 years | No difference | Multivariate Cox regression | Moderate | |
| Ghadri et al. (2018) | Modified Mayo criteria | 1613 | Prospective | 5 years | HR 1.65 (95% CI 1.14–2.40), P = 0.009 | Multivariable Cox regression | Moderate | |
| Joy et al. (2018) | ICD‐9 | 122 855 | Retrospective | In‐hospital | Primary TCM: Solid cancer: OR 3.43 (95% CI 1.38–8.52), P = 0.008 Secondary TCM: Haematological cancer: OR 3.21 (95% CI 2.31–4.48), P < 0.001; Metastatic cancer: OR 1.99 (95% CI 1.46–2.71), P < 0.001 | Multivariable logistic regression | High | |
| Kim et al. (2018) | Modified Mayo criteria | 257 | Prospective | Mean = 5.8 ± 3.6 years | HR 1.857 (95% CI 1.214–2.841), P = 0.004 | Multivariable Cox regression | Moderate | |
| Stiermaier et al. (2018) | Mayo criteria and ESC criteria (2016) | 826 | Prospective | Median = 2.5 years | HR 2.12 (95% CI 1.44–3.12), P < 0.001 | Multivariate Cox regression | Moderate | |
| Giannakopoulos et al. (2019) | Mayo criteria | 138 | Prospective | 5 years | HR 3.6 (95% CI 1.4–9.3), P < 0.01 | Multivariate Cox regression | Moderate | |
| Cammann et al. (2019) | Modified Mayo criteria | 1604 | Prospective | 10 years | HR 1.84 (95% CI 1.29–2.61), P = 0.001 | Multivariate Cox regression | Low | |
| Gietzen et al. (2019) | Mayo criteria | 138 | Prospective | 5 years | HR 3.6 (95% CI 1.4–9.3), P < 0.01 | Multivariate Cox regression | Moderate | |
| Misumida et al. (2019) | ICD‐9 | 22 818 | Retrospective | In‐hospital | OR 5.36 (95% CI 1.32–21.80), P = 0.02 | Multivariable logistic regression | High | |
| Yerasi et al. (2019) | ICD‐9 | 12 255 | Retrospective | In‐hospital | OR 2.61 (95% CI 2.04–3.32), P < 0.001 | Multivariate regression | High | |
| El‐Battrawy et al. (2020) | ESC criteria (2016) | 906 | Prospective | Mean = 1038 ± 838 days | HR 1.99 (95% CI, 1.3–2.9), P < 0.01 | Multivariate Cox regression | Moderate | |
| Núñez‐Gil et al. (2020) | Modified Mayo criteria | 1097 | Prospective | Median = 27.5 months | HR 1.73 (95% CI 1.04–2.87), P = 0.03 | Multivariate Cox regression | Moderate | |
| Ding et al. (2020) | In‐TAK criteria | 1676 | Prospective | 6 months | HR, 1.96 (95% CI 1.32–2.87) P = 0.001 | Multivariate Cox regression | Moderate | |
| Stiermaier et al. (2020) | Mayo criteria and ESC criteria (2016) | 147 | Prospective | 3 years | HR 4.32 (95% CI 1.53–12.19), P = 0.006 | Multivariable Cox regression | Moderate | |
| Napierkowski et al. (2021) | ICD‐9 | 14 639 | Retrospective | In‐hospital | OR 2.16 (95% CI 1.398–3.337), P = 0.001 | Multivariable logistic regression | High | |
| Kato et al. (2021) | Modified Mayo criteria | 1670 | Prospective | 5 years | HR 2.24 (95% CI 1.57–3.21), P < 0.001 | Multivariate Cox regression | Moderate | |
| BMI | Lower BMI vs. Higher BMI | |||||||
| Desai et al. (2018) | ICD‐9 | 1140 | Retrospective | In‐hospital | Non‐obesity (BMI < 30) vs. Obesity (BMI > 30): No difference | Propensity score matching | High | |
| Zalewska‐Adamiec et al. (2020) | Mayo criteria | 101 | Prospective | Mean = 7.2 years | BMI < 20 vs. ≥20: OR 0.857 (95% CI 0.738–0.995), P = 0.042 | Multivariable logistic regression | Moderate | |
| Mood diseases | Mood diseases vs. Non‐mood diseases | |||||||
| Isogai et al. (2014) | ICD‐10 | 3719 | Retrospective | In‐hospital | OR 0.43 (95% CI 0.19–0.96), P = 0.039 | Multivariable logistic regression | High | |
| Krishnamoorthy et al. (2015) | ICD‐9 | 7510 | Retrospective | In‐hospital | Anxiety or depression: No difference | Multivariable logistic regression | High | |
| Khera et al. (2016) | ICD‐9 | 11 193 | Retrospective | In‐hospital | No difference | Multivariable logistic regression | High | |
| Nayeri et al. (2017) | Mayo criteria | 306 | Prospective |
30 days 15 years |
No difference No difference |
Multivariable logistic regression | High | |
| Kim et al. (2018) | Modified Mayo criteria | 257 | Prospective | Mean = 5.8 ± 3.6 years | Depression: HR 1.764 (95% CI 1.155–2.694), P = 0.009 | Multivariate Cox regression | Moderate | |
| Cammann et al. (2019) | Modified Mayo criteria | 1604 | Prospective | 10 years | HR 1.40 (95% CI 1.01–1.94), P = 0.041 | Multivariate Cox regression | Low | |
| Syed et al. (2020) | ICD‐9 and ICD‐10 | 260 144 | Retrospective | In‐hospital | Depression: OR 0.63 (95% CI 0.60–0.69), P < 0.01 | Stepwise logistic regression | High | |
| Napierkowski et al. (2021) | ICD‐9 | 14 639 | Retrospective | In‐hospital | Anxiety: OR 0.592 (95% CI 0.399–0.880), P = 0.01 | Multivariable logistic regression | High | |
| Sepsis | Sepsis vs. Non‐sepsis | |||||||
| Isogai et al. (2014) | ICD‐10 | 3719 | Retrospective | In‐hospital | OR 2.02 (95% CI 1.17–3.49), P = 0.011 | Multivariable logistic regression | High | |
| Krishnamoorthy et al. (2015) | ICD‐9 | 7510 | Retrospective | In‐hospital | No difference | Multivariable logistic regression | High | |
| Khera et al. (2016) | ICD‐9 | 11 193 | Retrospective | In‐hospital | OR 6.93 (95% CI 2.54–18.93), P = 0.0002 | Multivariable logistic regression | High | |
| Napierkowski et al. (2021) | ICD‐9 | 14 639 | Retrospective | In‐hospital | OR 4.278 (95% CI 3.047–6.007), P < 0.001 | Multivariable logistic regression | High | |
| TCM vs. Non‐TCM | ||||||||
| Vallabhajosyula et al. (2018) | ICD‐9 | 10 746 | Retrospective | In‐hospital | OR 0.58 (95% CI 0.51–0.65), P < 0.001 | Multivariable logistic regression | High | |
| COPD | COPD vs. Non‐COPD | |||||||
| Khera et al. (2016) | ICD‐9 | 11 193 | Retrospective | In‐hospital | No difference | Multivariable logistic regression | High | |
| Li et al. (2020) | ICD‐10 | 1748 | Retrospective | In‐hospital | OR 2.93 (95% CI 1.39–6.15), P = 0.005 | Multivariable logistic regression | High | |
| Napierkowski et al. (2021) | ICD‐9 | 14 639 | Retrospective | In‐hospital | OR 1.444 (95% CI 1.140–1.829), P = 0.002 | Multivariable logistic regression | High | |
| HLD | HLD vs. Non‐HLD | |||||||
| Khera et al. (2016) | ICD‐9 | 11 193 | Retrospective | In‐hospital | No difference | Multivariable logistic regression | High | |
| Kato et al. (2017) | Modified Mayo criteria | 144 | Retrospective | In‐hospital | No difference | Multivariable logistic regression | Moderate | |
| Li et al. (2021) | ICD‐10 | 2324 | Retrospective | In‐hospital | OR 0.46 (95% CI 0.24–0.89), P = 0.027 | Multivariable logistic regression | High | |
| Anaemia | Anaemia vs. Non‐Anaemia | |||||||
| Gaede et al. (2021) | Mayo criteria | 126 | Prospective | Median = 4.4 years | OR 3.93 (95% CI 1.02–2.08), P = 0.015 | Multivariable logistic regression | Moderate | |
| Lu et al. (2021) | ICD‐10 | 1731 | Retrospective | In‐hospital | No difference | Multivariable logistic regression | High | |
BMI, body mass index; CI, confidence interval; CKD, chronic kidney diseases; COPD, chronic obstructive pulmonary disease; DM, diabetes mellitus; ESC, European Society of Cardiology; eGFR, estimated glomerular filtration rate; HLD, hyperlipidaemia; HR, hazard ratio; ICD, International Classification of Diseases; In‐TAK, International Takotsubo; NA, not applicable; OR, odds ratio; TCM, Takotsubo cardiomyopathy.