A-8 | Propensity Matched In-Hospital Outcomes of Acute ST Elevation Myocardial Infarction in Patients with Simultaneous Chronic Total Occlusion

Outcomes of STEMI in the presence of Chronic total occlusion (CTO) of a secondary vessel are not well known. The national readmission database (2016-2020) was utilized to identify hospitalizations for STEMI. 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 1, 011, 951 hospitalizations for STEMI, About 5. 53% (N: 55, 969) had CTO. After propensity matching (N=30, 459), patients with CTO had higher mortality (9. 3 vs. 8. 4%, p: 0. 05). CTO patients had similar readmission rates on 30- (9. 52 vs. 9. 08%, p=0. 07) and higher on 90-day (16. 57 vs. 15. 86%, p=0. 03) intervals, similar LOS (5 vs. 5 days, p<0. 05) & higher adjusted cost of hospitalization 171, 807 vs. 155, 5524, 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 STEMI hospitalizations, patients with CTO of a secondary vessel had higher mortality, complications, resource utilization & 90-day readmission rates.