Abstract 16440: Gender Differences of In-Hospital Outcomes in Acute Myocardial Infarction and Cardiogenic Shock Patients Using Impella: From the Nation Inpatient Sample 2016-2019

Abstract

Background: There is a lack of independent studies on gender differences in hospital outcomes with Impella in patients with acute myocardial infarction (AMI) combined with cardiogenic shock (CS). Our study aims to provide evidence on the impact of gender differences on AMI-CS patients receiving Impella with a nationally representative sample. Methods: Data were obtained from the National Inpatient Sample (NIS) from 2016 to 2019. Patients with AMI and CS were searched in the NIS using ICD-10 CM codes, and those with Impella were screened using ICD-10PCS codes. Patients treated with Impella were then stratified by gender. We used multivariate regression analysis with inverse probability weighting(IPTW) based on propensity scores to compare the risk of in-hospital death after Impella among patients of different genders. Results: From 2016-2019, a total of 2,953 inpatients with AMI combined with CS using Impella were identified. Of these, 28.5% were women. Women treated with Impella were older (mean age 68.42 versus 64.68 years, P<0.0001). Male inpatients on Impella had a higher proportion of NSTEMI, and were more likely to have smoking, congestive heart failure, cardiac arrhythmias, and acute renal failure. Female inpatients were more likely to have STEMI and were more likely to have Chronic pulmonary disease, uncomplicated hypertension, hypothyroidism, and valvular disease. After IPTW-adjusted baseline clinical covariates, women using Impella had a higher risk of in-hospital death than men, while length of stay and total hospital cost did not differ significantly between genders (OR, 1.33 [95%CI, 1.10-1.60]; Beta, -0.05 [95%CI, -0.80-0.71]; and Beta, 8105.24 [95%CI, -25376.84-9166.35]; respectively). Conclusions: Impella use was lower in women. However, in-hospital mortality was significantly higher in women among AMI-CS patients using Impella. Further studies are needed to explore the reasons for higher mortality in female patients using Impella.