A-49 | Propensity Matched In-Hospital Outcomes of Acute ST Elevation Myocardial Infarction of Left Anterior Descending (LAD) coronary artery in Patients with & without Chronic Total Occlusion of Coronaries

Chronic total occlusion (CTO) is a near-total blockage of a coronary artery often seen during percutaneous coronary intervention for acute coronary syndrome but not directly responsible for the event. The national readmission database (2016-2020) was utilized to identify hospitalizations for STEMI, with LAD as the culprit. Cohorts were stratified based on the presence of the CTO. A Propensity Score Matching (PSM) model matched CTO and non-CTO cases. Pearson's x2 test was applied to PSM-2 matched cohorts to compare outcomes. Among 98, 213 hospitalizations for LAD-STEMI, About 5. 53% (N: 5, 704) had CTO. After propensity matching (N=3, 197), patients with CTO had higher mortality (10. 95 vs. 7. 26%, p: 0. 05). CTO patients had similar readmission rates on 30- (10. 72 vs. 10. 20%, p=0. 52) and 90-day (18. 43 vs. 17. 35%, p=0. 33) intervals, similar LOS (3 vs. 3 days) & higher adjusted cost of hospitalization 195, 346 vs. 171, 793, p<0. 001. Female gender (aOR: 1. 16), DM (aOR: 1. 27), ESKD (aOR: 1. 27) & HF (aOR: 1. 39) were significant predictors of readmission while rehabilitation transfer was protective against readmissions (aOR: 0. 31) p<0. 001. In LAD-STEMI hospitalizations, patients with CTO have higher mortality, complications, and resource utilization, although MI complications & 90-day readmission rates were similar.