A-25 | Outcomes of STEMI in Patients with and without Liver Cirrhosis- A Propensity matched Multiyear Analysis

The association between liver cirrhosis & cardiovascular diseases is still a matter of debate. We aim to compare ST elevation MI (STEMI) outcomes in patients with & without liver cirrhosis. The national readmission database (2016-2020) was utilized to identify hospitalizations for STEMI. Cohorts were stratified by cirrhosis. A propensity score matching (PSM) model implemented Pearson's x2 test on matched cohorts to compare outcomes. Among 1 million hospitalizations for STEMI; 45,478 (4.4%) patients had a history of liver cirrhosis. After propensity matching (N=24,067), cirrhotic patients had higher in-hospital mortality (48.7% vs 17.3%, aOR: 6.8) & adverse events including stroke (6.8% vs 4.4%, aOR:1.7), SCA (24.4% vs 10.3%, aOR:3.3), cardiogenic shock (55.8% vs 21.1%, aOR: 6.2), MCS (36.2% vs 14.4%, aOR: 4.2) & pressor (15.1% vs 5.1%, aOR: 3.6) requirement, AKI (73% vs 34%, aOR:9.2), acute respiratory failure (64% vs 27%, aOR:7.1) & MACCE (61.4% vs 21.3%, aOR:6.5) [p<0.001]. The incidence of local post-MI complications (I23) was also higher in cirrhotic patients (3.3% vs 2%, aOR:1.9) including hemopericardium, ASD, VSD, rupture of cardiac wall & papillary muscles [p<0.05]. From 2016- 2020, STEMI mortality has not changed significantly for cirrhotics (p-trend>0.05). PCI use has increased from 47% to 55% (p-trend <0.001) while use of emergent CABG has not changed (∼1.6%, p-trend>0.05). In STEMI hospitalizations, cirrhotic patients have much higher mortality, complication rates & healthcare burden; despite increasing utilization of urgent PCI in cirrhotic patients, mortality has not changed significantly.