D-30 | Clinical Outcomes After Percutaneous Coronary Intervention in Patients with Multiple Sclerosis

Background: Multiple sclerosis (MS) is a chronic inflammatory and immune-mediated disorder that primarily affects the central nervous system.Increasing evidence suggests that chronic systemic inflammation and immune dysregulation are associated with heightened cardiovascular risk.Given the rising prevalence of MS, affecting approximately one million individuals in the United States, we sought to examine the association between MS and clinical outcomes following percutaneous coronary intervention (PCI) Methods: We performed a retrospective cohort study utilizing the TriNetX Global Collaborative Network.Adult patients (18 years) who underwent percutaneous coronary intervention (PCI) were identified using ICD-10-PCS and CPT procedure codes.Patients with multiple sclerosis (MS; ICD-10 G35) who underwent PCI were compared with PCI patients without history of MS.Propensity score matching was performed in a 1:1 ratio to balance demographics and cardiovascular comorbidities.Outcomes of interest included all-cause mortality, acute kidney injury (AKI), and stroke at 30 days and 1 year.Survival analyses were conducted using Kaplan-Meier estimates and Cox proportional hazards regression models Results: Following propensity score matching, 1,980 patients were included in each cohort (mean age 64 years; 54% female).At 30 days, all-cause mortality was comparable between patients with and without MS (2.4% vs 2.5%; hazard ratio [HR] 0.95, 95% confidence interval [CI] 0.64-1.41).However, MS patients experienced higher rates of acute kidney injury (8.0% vs 5.7%; HR 1.39, 95% CI 1.10-1.78).At 1 year, MS was associated with increased all-cause mortality (8.2% vs 6.1%; HR 1.35, 95% CI 1.07-1.71)and AKI (16.0%vs 12.0%; HR 1.35, 95% CI 1.14-1.59).Stroke incidence did not differ significantly between groups.Conclusions: Patients with multiple sclerosis undergoing PCI have an increased risk of acute kidney injury and higher 1-year mortality compared with those without MS.These findings suggest that MS may be an important modifier of post-PCI outcomes and should be considered in risk stratification and post-procedural surveillance.