Abstract 15263: Co-existing Systemic Lupus Erythematosus Does Not Negatively Impact Outcomes of Patients Admitted for Acute Coronary Syndrome: Analysis of the National Inpatient Sample

Abstract

Introduction: Systemic Lupus Erythematosus (SLE) is a chronic inflammatory autoimmune disease with effects on multiple organ systems and a wide range of clinical manifestations. Cardiovascular diseases from accelerated atherosclerosis are one of the major causes of mortality in SLE patients. This study aims to compare the outcomes of patients primarily admitted for Acute Coronary Syndrome (ACS) with and without a secondary diagnosis of SLE. Methods: Data were abstracted from the National Inpatient Sample (NIS) 2016 and 2017 Database. This database is the largest collection of inpatient hospitalization data in the United States (U.S). The NIS was searched for hospitalizations for adult patients with ACS as principal diagnosis with and without SLE as secondary diagnosis using ICD 10 codes. The primary outcome was inpatient mortality. Secondary outcomes of interest are showed in Table 1. Multivariate logistic and linear regression analysis was used accordingly to adjust for confounders. STATA software was used to analyze the data. Results: There were over 71 million discharges included in the combined 2016 and 2017 NIS database. Out of 1.3 million patients with ACS, 5,485 (0.42%) had SLE. The adjusted odds ratio (AOR) for inpatient mortality for ACS with co-existing SLE compared to those without SLE was 1.16 (95% CI 0.86-1.56, P=0.333). Hospitalizations for ACS with co-existing SLE had a decrease in adjusted mean total hospital charge of $5,164 compared to those without SLE (95% CI - {10,202-126}, P=0.045). Conclusions: Patients admitted primarily for ACS with a secondary diagnosis of SLE had less total hospital charges, but similar inpatient mortality, LOS, revascularization strategies, rates of IABP and PEAD placement compared to those without SLE. Though SLE is known to increase the risk of cardiovascular diseases, SLE does not negatively impact outcomes in patients primarily admitted for ACS based on U.S. national hospital billing data.