A-7 | Propensity Matched In-Hospital Outcomes of Acute ST Elevation Myocardial Infarction Among Opioid Users

Opioid use has grown exponentially in the last 30 years. We aim to compare STEMI outcomes in patients with About 0.8% (N: 8,575) had OUD. After propensity matching (N=4,875), patients with OUD had higher mortality (13.4% vs 11.4%, aOR:1.27, p: 0.002); although rates of MI complications & sudden cardiac arrest were similar in the two cohorts (p>0.05). Opioid users were found to have lower utilization of PCA (70.5% vs 78.3%), PCI (48.9% vs 60.8%) & DES implantation (42.7% vs 53.4%) p<0.001 but a higher bare metal stent/angioplasty (7.4% vs 5.6%, p:0.004). Opioid users had higher readmission rates on 30-day (13.7% vs 10%), 90 & 180-day intervals, higher LOS (4 vs 3 days) & cost of hospitalization p<0.001. Female gender (aOR: 1.23), DM (aOR: 1.37), ESKD (aOR: 2.2) & HF (aOR:1.6) were significant predictors of readmission while rehabilitation transfer was protective against readmissions (aOR:0.8) p<0.001. In STEMI hospitalizations, opioid users have higher mortality, lower rates of revascularizations, and higher readmission rates.