A-59 | Comparison of early vs late percutaneous coronary intervention in cirrhosis patients admitted with NSTEMI

Although multiple clinical trials have evaluated management strategies for NSTEMI, most of them have excluded cirrhotic patients. Thus optimal timing of percutaneous coronary intervention in patients with NSTEMI and cirrhosis remains understudied. We utilized the Nationwide Inpatient Sample database from 2016 to 2019 to perform this retrospective study. Hospitalized patients with diagnosis of NSTEMI and cirrhosis were identified. They were stratified into early PCI groups if the time from admission to PCI was less than 1 day and late PCI if it was more than 1 day. Our primary aim was to compare difference in in-hospital mortality A total of 16,275 patients with cirrhosis were admitted with NSTEMI. In this population, 2,380 (14.6%) underwent PCI, with 1520 (64%) undergoing early and 860 (36%) having late PCI. The overall mortality rate among patients who underwent early, and late PCI were similar (3 vs 3.5%, p=0.582). Patients who underwent late PCI had higher rates of AKI (18.4 vs 30.8, p=0.004) and acute decompensated heart failure (12.5 vs 27.3, p=0.005). The average length of stay (3.9 vs 8 days, p=<0.001) and total hospital charges (111,159 vs 153,097, p=0.001) were lower among those with early PCI. There were no significant differences in rates of cardiogenic shock, cardiac arrest, ventricular tachycardia and ventricular fibrillation among those who underwent early and late PCI (Table 1). Our study shows that cirrhosis patients with NSTEMI who undergo early PCI have lower rates of AKI, ADHF, length of hospital stay and total hospital charges. Dedicated trials for this sub-population is required to confirm these findings.