Abstract 12810: Short-Term Hospital Outcomes of Elderly Patients With Mechanical vs. Bioprosthetic Heart Valves Admitted for NSTEMI

Abstract

Introduction: Valvular heart disease(VHD) is a significant cause of morbidity and mortality among the elderly. While the use, merits, and demerits of mechanical heart valves (MHV) and bioprosthetic heart valves(BHV) to treat VHD are well-documented in the literature, there needs to be more data on the outcomes following events of NSTEMI. Methods: We explored the 2016-2020 National Inpatient Sample for patients ages≥60 years hospitalized for a primary diagnosis of NSTEMI via their ICD-10 codes. We further retained those with a presence of MHV or BHV, and differences in outcomes between the two groups were evaluated. Results: Our study found 32775 adults of age 60 and more hospitalized with NSTEMI, which included 23670 (72.2%) cases with MHV, while 9105 (27.8%) patients had a BHV. No differences in mean Charlson Comorbidity Index (CCI) scores were found between the two groups (mean CCI in MHV patients: 4.14 vs. 4.22 in those with BHV, p=0.233). Compared to cases with BHV, those with MHV showed higher odds of acute kidney injury (aOR 1.108, p<0.01), atrial fibrillation (aOR 1.110, p<0.01), supraventricular tachycardia (aOR 1.46, p<0.01), and use of CABG (aOR 1.289, p=0.031). However, patients with MHV were less likely to undergo PCI for NSTEMI than those with BHV (aOR 0.781, p<0.01). No differences between the two cohorts were found for events of ventricular tachycardia (aOR 0.907, p=0.072), ventricular fibrillation (aOR 1.021, p=0.80), cardiogenic shock (aOR 1.012, p=0.876), or death (aOR 0.928, p=0.187). Finally, those with MHV reported a slightly more extended stay (mean length of stay 4.41 days) than those with BHV (mean length of stay 4.02 days, p<0.01). Conclusions: Patients with MHV showed higher odds of complications such as AKI, Atrial fibrillation, supraventricular tachycardia, and use of CABG following NSTEMI while reporting lower odds of PCI use than those with BHV.