Abstract 11761: Increasing Trend in All-Cause Mortality Among Elderly Black Patients Hospitalized With Acute Myocardial Infarction With Prior Coronary Artery Bypass Grafting - A Nationwide Inpatient Analysis 2016-2019

Abstract

Background: Acute myocardial infarction (AMI) in elderly patients who have previously undergone coronary artery bypass grafting (CABG) poses a diagnostic and therapeutic complexity. There is limited data on cardiovascular and mortality outcomes for this population. Methods: Using the National Inpatient Sample (NIS) from 2016-2019, we identified patients over 65 years with a prior CABG presenting with AMI, excluding those with a history of percutaneous coronary intervention. After assessing baseline characteristics, we analyzed trends in cardiovascular disease (CVD) risk and all-cause in hospital mortality (ACM) while stratifying for gender and race. Pearson’s chi-squared test was utilized to compare the CVD variables. Results: There were 266,365 hospitalizations included in the study with a median age of 77 years. They were predominantly males(69.5%), of Caucasian origin (81.7%), Medicare enrollees (91.4%) and were admitted in urban teaching hospitals (67.2%) located in the South of the US (39.5%) as non-elective cases (93.8%). Between 2016-19, Hyperlipidemia (HLD), smoking(Sm), and obesity(Ob) showed an increasing trend in males (2.8%, 1.3%, and 2% respectively) and females (2.1%, 2.4%, and 2% respectively), whereas hypertension (HTN) decreased by 4.5% in males and 6.3% in females.The length of stay remained constant at 4 days and the average cost of stay was 58963.5 USD. HTN among all races decreased from 2016 to 2019 except for Native Americans. HLD and obesity exhibited an upward trend among all races. Hispanics and Asians/Pacific Islanders(PI) had a consistent downtrend in mortality rates, with Native Americans showing the biggest drop in mortality rate (6.9%). All-cause mortality decreased from 2016 to 2019 by 1.4% except for Blacks which has increased by 2.6%, overtaking Asian/PI. All p<0.001. Conclusion: More research is needed to determine the factors contributing to the increased all-cause mortality trend in Black patients admitted with AMI.