A-62 | Chronic Heart Failure's Influence on Clinical Outcomes in STEMI Patients Undergoing Percutaneous Coronary Intervention

ST-elevation myocardial infarction (STEMI) is a critical cardiovascular emergency, and percutaneous coronary intervention (PCI) plays a pivotal role in its management. Despite significant advancements in PCI, the impact of chronic heart failure (CHF) on the prognosis of STEMI patients undergoing this intervention remains insufficiently explored. This study aims to investigate outcomes in this patient population. This retrospective cohort study utilized data from the United States National Inpatient Sample database (2016-2020). Identification of patients with STEMI undergoing PCI and stratification based on CHF diagnosis were performed using ICD-10 codes. In-hospital complications were assessed using multivariate regression analysis to adjust for potential confounders. Among 1,348,770 STEMI patients undergoing PCI, 6.13% had CHF. When comparing the CHF to the non-CHF cohort, 35.7% were female, compared to 32.2%, and the average age was 68, compared to 64. CHF patients exhibited lower rates of in-hospital mortality (aOR 0.66; 95% CI 0.60-0.72; P < 0.001), mechanical ventilation necessity (aOR 0.63; 95% CI 0.59-0.68; P < 0.001), acute hypoxic respiratory failure (aOR 0.53; 95% CI 0.50-0.56; P < 0.001), ventricular arrhythmias (aOR 0.85; 95% CI 0.81-0.89; P < 0.001), and sepsis (aOR 0.86; 95% CI 0.79-0.94; P = 0.001). However, this cohort had higher rates of atrial fibrillation (aOR 1.44; 95% CI 1.38-1.50; P < 0.001) and atrial flutter (aOR 1.31; 95% CI 1.19-1.44; P < 0.001). No significant difference was observed between the two cohorts in pericardial complications, vascular complications, gastrointestinal bleeding, ischemic stroke, intracranial hemorrhage, and acute kidney injury. While CHF patients with STEMI undergoing PCI exhibit favorable trends with reduced in-hospital mortality and complications, the elevated risk of atrial fibrillation and atrial flutter emphasizes the complexity of their clinical course. These findings underscore the importance of personalized management for these patients. Further research is crucial to understand the mechanisms and refine clinical strategies for optimal outcomes in this challenging patient population.