B80-3-01 Predictors of In-hospital Mortality in Patients With Acute Myocardial Infarction and Obstructive Sleep Apnea: A Nationwide Analysis

Abstract Introduction/Rationale Acute myocardial infarction (AMI) remains a leading cause of in-hospital mortality. Obstructive sleep apnea (OSA) has increasingly been recognized as a modifiable contributor to adverse cardiovascular outcomes. Patients with AMI and OSA may experience worse clinical outcomes; however, evidence regarding factors associated with in-hospital mortality in this population remains limited. Identifying these factors may enhance risk assessment and management strategies. Methods A retrospective cross-sectional analysis of the National Inpatient Sample (NIS) from 2018 to 2021 was conducted. Adult hospitalizations (≥ 18 years) with primary diagnosis of acute myocardial infarction (ICD-10 I21.0-I21.4, I21.9) and a concurrent diagnosis of obstructive sleep apnea (G47.33) were included. The primary outcome was in-hospital mortality; secondary outcomes included length of hospital stay. Demographics and clinical comorbidities were analyzed as potential predictors of the outcome. Associations between categorical variables and mortality were evaluated using the Chi-square test, with statistical significance set at p 0.05. Statistical analyses were performed using IBM SPSS Statistics version v25.0. Results A total of 20,771 patients with acute myocardial infarction and obstructive sleep apnea were included, with a mean age of 67 years; 66.3% of the patients were male. The in-hospital mortality rate was 5.2%. Mortality was significantly higher among patients aged ≥60 years (p 0.001). Race showed a mild association with higher mortality in Caucasian patients (p = 0.03). Comorbid conditions, including chronic kidney disease (p 0.001), congestive heart failure (p 0.001), diabetes mellitus (p = 0.032), chronic obstructive pulmonary disease (p = 0.004), and coagulopathy (p = 0.018), were significantly associated with mortality. No significant associations were observed for hypertension, obesity, dyslipidemia, alcohol use, or tobacco use. Discussion Our findings indicate that cardiorenal and pulmonary comorbidities increase the risk of in-hospital mortality in patients with AMI and OSA. These conditions may compromise hemodynamic stability and respiratory function, worsening the ischemic injury and recovery time, leading to longer hospitalizations and poorer outcomes. Conclusion Patients with AMI and OSA present elevated in-hospital mortality, especially when cardiorenal or pulmonary comorbidities coexist. Early identification and targeted management are crucial for reducing mortality and improving patient outcomes. This abstract is funded by: None