A-48 | STEMI in End Stage Renal Disease Population with and without the history of Renal Transplantation

End-stage renal disease (ESRD) patients are at a high risk for cardiovascular (CV) mortality. Renal transplantation (RT) improves quality of life & improves survival in ESRD; however, reduction in CV mortality is understudied. We aim to compare STEMI outcomes in ESRD patients with & without a history of RT. The national readmission database (2016-2020) was utilized to identify hospitalizations for STEMI in ESRD patients. Cohorts were stratified by history of RT. A Propensity Score Matching (PSM) model matched RT & non-RT patients. Pearson's x2 test was applied to PSM-2 matched cohorts to compare outcomes. Among, 2891 hospitalizations for STEMI in ESRD patients; 32.8% had a history of prior RT. After propensity matching (N=1,084), non-RT patients had higher complications including mortality (37.6% vs 15.2%, aOR:3.82, p <0.001), sudden cardiac arrest (26.4% vs 8.4%, aOR:3.6, p<0.001), cardiogenic shock (34.2% vs 18.6%, aOR:3.3, p<0.001), need for mechanical support modalities (24.2% vs 14.6%, aOR:3.2, p<0.001) & CABG (6.2% vs 4.2%, aOR:1.88, p: 0.042). RT had higher utilization of PCA (66.7% vs 51.1%, p<0.001), PCI (24.2% vs 14.6%, p<0.001), DES implantation (49.1% vs 32.5%, p<0.001) & readmission rates on 30-day (17.5% vs 10.2%, p<0.001) & subsequently at 90-day & 180-day intervals [p<0.001]. Non-RT patients had higher LOS (8 vs 3 days) & cost of hospitalization ($46,448 vs $24,909) [p<0.001]. In STEMI hospitalizations in ESRD patients, patients without a history of renal transplant tend to suffer higher mortality, adverse events & resource utilization; However, readmission rates are higher in RT patients.