Abstract P119: Patients With Arterial Hypertension And Hypertrophic Cardiomyopathy Affected By Pulmonary Hypertension Have Worse Clinical Outcomes, Nation-wide Study

Abstract

Background: HCM is a predominantly genetic disorder affecting the cardiac muscle and its functionality. PH is a known predictor of adverse outcomes. There is limited evidence of clinical outcomes in HCM population with HTN (as a surrogate for preserved contractility) affected by PH. Methods: We queried NIS between 2017-2020 for adult patients with HCM&HTN who had PH. The primary outcome was mortality. The secondary outcomes were cardiogenic shock, cardiac arrest, intubation, length of stay (LOS) and total hospital cost. Multivariable logistic and Poisson regression analyses were used to estimate outcomes. Results: There were 35,640 hospitalizations with HCM&HTN, of which 1950 (5.4%) had PH. PH and non-PH cohorts were with mean age of 71.6 vs. 65.2 yrs; males 35.2% vs 48.6%; Caucasians 67.3% vs 65.9%; HF 16.8% vs 4.1%; sHF 2.8% vs 0.9%; dHF 13.2% vs 2.8%; ACS 14.2% vs 13.6%; STEMI 1% vs 0.8%; obesity 22.7% vs 21.1%; anemia 18.8% vs 12.7%; AF 52.8% vs 32%; CKD 4% vs 1.4%; history of MI 10.2% vs 9.3%; COPD 29.8% vs 15.7%, respectively. PH cohort had significantly worse clinical outcomes and resource utilization (Table 1). Conclusion: HCM patients with HTN and co-existent PH had significantly higher rates of cardiogenic shock and higher resource utilization. There is a tendency to higher mortality in cohort with PH. This cohort was older, white females with more prevalent HF (systolic and diastolic), ACS, anemia, AF, obesity, CKD, past MI, COPD. PH is associated with increased rates of heart failure, cardiac arrhythmias, pulmonary and renal diseases. Detection and appropriate management of PH in patients with cardiomyopathies may have clinical benefit and play a role in prognostication.