94 Incidence and timing of adverse cardiac outcomes after vascular surgery: A real-world evidence study

Objectives/Goals: Findings from cohort studies report a 1-year major adverse cardiac event (MACE) rate of 15% after vascular surgery. However, the real-world evidence (RWE) of the timing, incidence, and profile of these events is limited. We hypothesize that the MACE rate from RWE data will exceed current estimates. Methods/Study Population: Patients undergoing elective, intermediate- or high-risk vascular surgery at University of Maryland Medical System (1/1/2016—9/30/2025) were analyzed retrospectively. Data on six MACE outcomes (all-cause mortality, myocardial infarction, coronary revascularization, heart failure decompensation, cardiogenic shock, nonfatal cardiac arrest) were extracted from the Electronic Health Record utilizing algorithms incorporating ICD-10 codes, Current Procedural Terminology (CPT) codes, and clinical variables. We calculated the cumulative postoperative MACE incidence at 7-days, 30-days and 1-year following surgery. Results/Anticipated Results: We identified 9,490 patients of whom N=6,180 (65%) were male, N=6,327 (67%) were white, and N=2,755 (29%) were black or African American. We will describe baseline characteristics, comorbidities, pre-operative radiographic results and laboratory values for the study cohort. The primary endpoint is cumulative MACE incidence at 30-days. Secondary endpoints include composite MACE incidence at 7-days and 1-year, as well as outcomes stratified by individual MACE parameters. Discussion/Significance of Impact: This retrospective study aims to provide a detailed characterization of MACE following vascular surgery. The derived data are anticipated to inform pre-operative risk stratification for real-world scenarios and in doing so identify opportunities for preventative interventions targeting MACE.