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Cardiac amyloidosis (CA) is an increasingly recognized and fatal cause of heart failure. However, its impact on cardiovascular outcomes in patients with ST-elevation myocardial infarction (STEMI) is not well-described in the literature. Methods: Using data from the National Inpatient Sample database (2016-2019), we conducted a cohort study to identify hospitalizations for STEMI based on ICD-10 codes, stratifying them by the presence of cardiac amyloidosis. We employed chi-square tests for categorical variables, t-tests for continuous variables, and multivariate logistic regression analysis to adjust for potential confounders of the outcomes. Results: A total of 703,930 STEMI hospitalizations were analyzed. Of these 1705 (0.24%) had CA with a mean age of 74.9 years compared to non-amyloid group 63.5 years (p=0.034). In univariate analysis, CA was associated with higher in-hospital mortality (OR: 3.79, p=0.005). However, after adjusting for demographics, comorbidities, and hospital characteristics, there were no significant differences for the in-hospital mortality, length of stay (LOS) or the odds of experiencing cardiogenic shock and cardiac arrest. Patients with CA had lower odds of undergoing Primary Coronary Intervention (PCI) (OR: 0.3, p=0.005) (see figure 1). Conclusions: In this study Patients with STEMI and CA did not exhibit higher in-hospital mortality or longer hospital stay but were less likely to undergo PCI. Further investigation is needed to compare outcomes between AL and ATTR amyloidosis in this context. A. Wardhere, A. Mohamoud, D. Bampatsias, M. Nor, Nothing to disclose.
Wardhere et al. (Wed,) studied this question.