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 & without opioid use disorder (OUD). The national readmission database (2016-2020) was utilized to identify hospitalizations for STEMI. Cohorts were stratified by the presence of OUD. A Propensity Score Matching (PSM) model matched opioid users & non-users. Pearson's x2 test was applied to PSM-2 matched cohorts to compare outcomes. Among 1 million hospitalizations for STEMI; 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.