Abstract 18683: Prevalence of Obesity in Transgender Adults and Its Impact on Major Adverse Cardiac and Cerebrovascular Events and Pulmonary Embolism: A Population-Based Analysis

Abstract

Introduction: Although obesity and its impact on major adverse cardiac and cerebrovascular events (MACCE) and pulmonary embolism(PE) have been extensively studied, little is known about obesity’s impact on MACCE and PE in the transgender population. Through this study, we sought to establish the prevalence of obesity and its impact on MACCE outcomes and PE in this population subset. Methods: Using the National Inpatient Sample 2020 database, we identified admissions of transgender patients or patients with prior sex reassignment surgery using ICD-10 CM Codes. Later, all these patients were divided into obesity and non-obesity cohorts. Multivariate regression analysis was then performed for in-hospital MACCE and PE to calculate the odds ratio (OR). Predictors for MACCE were also identified in transgender patients with obesity. Results: In 2020, 19,345 transgender patients or patients who had sex reassignment surgery were admitted to the hospital; 16,390 (84.7%) had no obesity, and 2,955 (15.3%) had obesity. In the obesity cohort, 64.5% of patients had a mean age between 18-44 years, 66.5% were white, 47.9% were transgender males, and 52.1% were transgender females. The most common comorbidities include hypertension (43.5%), diabetes (32.5%), and chronic pulmonary disease. (27.7%). Among the transgender patients with obesity, 5.4% had MACCE events, and 1.2% had cardiac arrest. A statistically significant association was observed in MACCE [OR 2.1, 95% confidence interval (CI) 1.24-3.55, p=0.006] and cardiac arrest (OR 3.92, 95% CI 1.11-12.63, p=0.022 among obesity cohort, with age being the important predictor of MACCE. However, no statistically significant association was observed in acute myocardial infarction (OR 1.82, 95% CI 0.8503.93, p=0.125), acute ischemic stroke (1.34, 95% CI 0.39-4.62, p=0.638) and PE (2.18, 95% CI 0.83-5.72, p=0.113). Conclusion: We observed increased odds of MACCE and cardiac arrest in transgender patients with obesity in our large population-based analysis. This observation could be a result of hormonal treatment that transgender adults receive or associated disparities with transgender care. Further large-scale studies are needed to understand the impact of obesity and MACCE events, and PE in this population.