A-6 | Outcomes of ST Elevation Myocardial Infarction in Young Patients with Stimulant Use

Stimulant drug use causes a variety of acute & chronic cardiovascular toxicities, with ACS being the most common acute presentation. Most stimulant-associated MI tend to have normal coronaries. We aim to compare STEMI outcomes in stimulant users & non-users. The national readmission database (2016-2020) was utilized to identify hospitalizations for STEMI in patients aged <50 Years. Cohorts were stratified by the simultaneous presence of stimulant use (cocaine, methamphetamine). Mahalanobis distance propensity matching was utilized. Pearson's x2 test was applied to PSM-matched cohorts to compare outcomes. Among 134,391 hospitalizations for STEMI, About 5.4% (N: 7,304) had a history of stimulant use. After propensity matching (N=3,920), stimulant users had higher mortality (8.3% vs 6.3%, aOR:1.39, p: 0.001), although rates of MI complications & sudden cardiac arrest were similar in the two cohorts (p>0.05). Stimulant users were found to have lower utilization of PCA (81.3% vs 84.4%), PCI (55.1% vs 65.7%), and drug-eluting stent (DES) placement (45.9% vs 59.7%) but higher rates of a bare metal stent (BMS) or angioplasty (12.2% vs 6.5%) [p<0.001].Stimulant users had higher readmission rates on 30-day (11.9% vs 8.1%) & 90-day (19.6% vs 14.1%) intervals, higher LOS (3 vs 2 days) [p<0.001] but the similar cost of hospitalization as non-users (p>0.05). Female gender (aOR: 1.41), DM (aOR: 1.4), CKD (aOR: 1.62) & HF (aOR:1.6) were found to be significant predictors of readmission [p<0.001]. In STEMI hospitalizations, stimulant users have higher mortality and readmission rates and lower rates of revascularizations.