Abstract 4135252: Associations between Group 2 Pulmonary Hypertension and 30-Day Readmissions Following Acute Myocardial Infarction Hospitalizations.

Abstract

Background: Pulmonary hypertension (PH) is a major contributor to cardiovascular disease-related morbidity and mortality. Despite this, little is known regarding the outcomes of 30-day re-admissions following Acute Myocardial Infarction (AMI) in the context of group 2 PH. Hypothesis: Group 2 PH is associated with a higher likelihood of 30-day readmissions in patients presenting with AMI. Goal: To assess the relationship between group 2 PH and adverse hospitalization outcomes in cases of AMI. Methods: We queried the 2016-2020 Nationwide Readmission Database (NRD) and identified AMI as the primary diagnosis. We compared in-hospital outcomes based on the presence versus absence of Group 2 PH. The primary outcome was 30-day readmissions. Secondary outcomes included the odds of in-patient mortality, mechanical ventilation use, vasopressor use, and mechanical circulatory support (MCS) use. Multivariable regression models were used to adjust for confounders. Results: Among 182,308 AMI hospitalizations, 364 (0.2%) had a secondary diagnosis of Group 2 PH. Group 2 PH was associated with a higher likelihood of re-admission within 30 days (adjusted OR [aOR] 1.21, 95% CI 1.07–1.36, p=0.002). Additionally among patients presenting with AMI, group 2 PH was associated with higher odds of in-patient mortality (aOR 2.64, 95% CI 1.52–4.58, p=0.001), mechanical ventilation use (aOR 2.07, 95% CI 1.19–3.6, p=0.010), vasopressor use (aOR 5.4, 95% CI 2.7-10.9, p<0.001) and MCS use (aOR 2.39, 95% CI 1.46-3.91, p<0.001) during index hospitalization compared to the patients without group 2 PH. Conclusion: Patients with Group 2 PH admitted for AMI had higher odds of 30-day readmissions and both fatal and non-fatal adverse outcomes compared to patients without PH. Further studies are needed to confirm these findings and develop strategies to improve outcomes for this high-risk population.