Abstract 18054: Contemporary In-Hospital Outcomes of Congestive Heart Failure With Multiple Myeloma; a Regression Matched Analysis

Abstract

Introduction: Multiple myeloma (MM) is a disease commonly found in elderly individuals and is associated with a high burden of cardiovascular comorbidity. Various disease manifestations in MM, including amyloidosis, anemia, hyperviscosity, hypercalcemia, intramedullary arteriovenous fistula formations, and chemotherapy-related complications, contribute to an increased risk of congestive heart failure (CHF). The objective of this study was to examine the clinical outcomes of MM patients admitted with CHF. Methods: The National Inpatient Sample database from 2016-2020 was queried to identify patients with a primary diagnosis of CHF and stratified based on the presence of MM. The primary outcome measured was in- hospital mortality. The adjusted odds ratio (aOR) of in-hospital outcomes were calculated using software STAT v.17. Results: Of the 536,700 primary hospitalizations with CHF, 1,965 (0.36%) had MM. On adjusted analysis, the CHF-MM cohort had a higher odds of cardiac arrest (aOR 2.5, 95% CI 1.2-5.5), need for new hemodialysis (aOR 2.4, 95% CI 1.6-3.6) and GI bleeding (aOR 2.1, 95% CI 1.1-3.8) However, there was no statistically significant difference in the odds of in-hospital mortality, stroke, AMI or major bleeding. Furthermore, the presence of MM in CHF related hospitalizations was not associated with higher length of stay and adjusted total cost. Conclusion: Our study reveals that MM patients admitted with CHF have an increased risk of cardiac arrest, new hemodialysis, and GI bleeding. To optimize cardiovascular outcomes in this high-risk patient population, a multidisciplinary approach involving hemato-oncologists and cardiologists is necessary.