Abstract 13162: Temporal Trends in Secondary Pulmonary Hypertension and Subsequent Mortality in Hospitalized Geriatric Patients With Prior Revascularized Myocardial Infarction (2016-2019)

Abstract

Background: There is limited data on the burden and impact of Pulmonary hypertension (PHTN) in geriatric patients with prior revascularized MI. This study aims to explore the burden, trends, and impact of secondary PHTN on the survival of elderly patients with established CVD risk. Methods: We used the National Inpatient Sample (2016-2019) to identify geriatric (≥65 years) hospitalizations with prior revascularized MI (PCI or CABG) by using ICD-10 codes and divided them into two groups: with secondary PHTN and without secondary PHTN (GPRMI-PHTN+ VS. GPRMI-PHTN-). We then compared the two groups' morbidity, mortality, and associated outcomes. Results: Of 2265900 GPRMI patients that were included in the study, 169942 (7.5%) had secondary PHTN (median 76 [70-82]). The PHTN cohort often had females (42.5% vs 33.7%) and blacks (10.8% vs 7.7%) than the cohort without PHTN (p<0.001). The PHTN group often consisted of higher rates of diabetics (49.8% vs 46.3%) and smokers (45% vs 43.9%) (all p<0.005). The PHTN cohort had a higher all-cause mortality rate (3.7% vs 2.6%), often required home health care (26.7% vs 21.3%), transfers to other care facilities (23.4% vs 21.7%), with prolonged hospital stays (median 4 vs 3 days), and had higher hospital costs (all p<0.005). A significant decline in morbidity and mortality was noted temporally among males, females, and whites, but not in black, hispanic, and asian populations. Conclusions: PHTN is strongly associated with morbidity and mortality in geriatric patients with a prior history of revascularized MI. Prospective studies on such patients with long-term follow-up are warranted to establish trends and disparities among different populations and prevent worse outcomes.