D-42 | Determinants and Factors for Readmission and In-Hospital Mortality in Pulmonary Arterial Hypertension Patients Undergoing CTO-PCI

Percutaneous coronary intervention (PCI) for chronic total occlusions (CTO) presents increasing complexity in the presence of pulmonary arterial hypertension (PAH). This study aims to delineate the influence of PAH on in-hospital mortality and readmission rates among patients undergoing CTO-PCI, addressing a notable gap in current research. Analyzing data from the National Readmission Database (2016-2020), we identified patients admitted for CTO and undergoing PCI, subsequently stratifying them based on PAH diagnosis. Multivariate regression analysis was employed to examine the impact of PAH on primary (in- hospital mortality) and secondary (readmission rates) outcomes. Our findings indicated pronounced impact of PAH in the CTO-PCI patient cohort. Patients with PAH exhibited higher in-hospital mortality (1.1%) compared to non- PAH patients (0.7%). Also, the readmission rate was significantly higher in the PAH group (10.2% vs. 7% in non-PAH patients). PAH patients were older (mean age 72 vs. 66, p = 0.001) and had a higher prevalence of comorbid conditions such as congestive heart failure, electrolyte derangement, diabetes mellitus, acute kidney injury and longer hospital stays. This study reported heightened risks associated with PAH in patients undergoing CTO-PCI. This finding should be a call for enhanced clinical vigilance in care of this patients. Further research works in this field would help to develop guidelines in the care of the demographic.