Abstract 17956: In Hospital Outcomes of Patients With Acute Coronary Syndrome With Underlying Immune Thrombocytopenia Purpura

Abstract

Introduction: Acute coronary syndrome (ACS) represents a significant health burden worldwide. Immune thrombocytopenia (ITP), a condition characterized by low platelet due to immune-mediated destruction, has been associated with increased bleeding risk and altered hemostatic balance. This abstract aims to summarize a research study investigating the in-hospital outcomes of patients diagnosed with both ACS and underlying ITP, shedding light on the unique challenges posed by this comorbidity Methods: We queried the National Inpatient Sample (NIS) database from 2016 to 2020. The NIS was searched for hospitalization of adult patients with Acute Coronary Syndrome as a principal diagnosis with and without ITP as a secondary diagnosis using ICD-10 codes. The primary outcome was inpatient mortality .The secondary results were sepsis, acute kidney injury (AKI), Cardiogenic shock (CS), Cardiac arrest (CA), Total hospital charge (THC), pulmonary embolism (PE), and length of stay (LOS). Multivariate logistic and linear regression analysis were used accordingly to adjust for confounders. Results: About 1200515 patients were admitted for ACS, 0.19% (2225) had underlying ITP, Compared with those with ITP, there is statistically significant increase in LOS (8.85 vs 6.26, p<0.004, IRR=1.16,), THC (161275.7 vs 116208.7, p<0.003, IRR=31221.23,) and statistically significant decrease in cardiogenic shock (4.94% vs 5.94%,p<0.039, OR=0.62, 95%CI 0.4-0.98). But there were no statistical significance in Death (13.93% vs 9.8%, p<0.405, OR=1.13, 95%CI 0.84-1.51), sepsis (23.15% vs 18.0%, p<0.728, OR=0.96, 95%CI 0.75-1.22), AKI (35.5% vs 46.52%, p<0.395, OR=1.09, 95%CI 0.89-1.35), PE (2.7% vs 2.49%, p<0.448, OR=0.78, 95%CI 0.41-1.47), and All_CA (13.03% vs 9.87%, p<0.375, OR=1.29, 95%CI 0.73-2.3). Conclusions: These findings suggest that while ACS patients with underlying ITP may have certain differences in LOS, healthcare charges, and cardiogenic shock rates, they do not appear to be at significantly increased risk for mortality or other major complications. Additionally, the lower incidence of cardiogenic shock in the ITP group may indicate potential protective effects or differences in underlying pathophysiology, warranting further investigation