Abstract P586: Patients With Heart Failure and Chronic Kidney Disease Affected by Pulmonary Hypertension Have Greater Risk of Mortality and Worse Clinical Outcomes

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Background: Heart failure (HF) and chronic kidney disease (CKD) are increasingly prevalent diseases worldwide. Pulmonary hypertension (PH) is a known predictor of adverse outcomes. Nevertheless, there is limited scientific evidence of clinical outcomes of PH in patients with HF and CKD. Therefore, we sought to investigate this population. Methods: We queried NIS between 2016-2019 for adult patients who were hospitalized with HF and CKD and were affected by PH. The primary outcome was inpatient mortality. The secondary outcomes were cardiogenic shock, cardiac arrest, acute kidney injury (AKI), invasive mechanical ventilation, length of stay (LOS) and total hospital charge. Multivariable logistic and Poisson regression analyses were used to estimate clinical outcomes. P-value < 0.05 was significant. Results: There were 9,221,158 patients with HF and CKD, of which 85,985 (4.3%) had PH. PH and non-PH cohorts were with mean age of 73.3 vs. 72.3 yrs; males 46.8% vs 55.1%; Caucasians 62.5% vs 63.2%; systolic HF 42.2% vs 41.7%; obesity 26.1% vs 22.2%; dyslipidemia 56.1% both; anemia 25.3% vs 21.9%, DM 54.3% vs 58.5%; AF 53.4% vs 41.5%; history of MI 14.4% vs 16.3%; stroke 1.6% vs 2.3%; COPD 39.6% vs 33.1%, smokers 9% vs 11%, respectively. PH cohort had significantly higher mortality and worse clinical outcomes (Table 1). Conclusion: HF patients with CKD who had PH showed significantly worse clinical outcomes and higher resource utilization. They were older, females, with more frequent systolic HF, obesity, anemia, AF, COPD. PH may raise risk for systolic dysfunction, cardiometabolic syndrome and lung disease. Hence, early detection and treatment of PH may improve clinical outcomes when managing patients with HF and CKD. Future studies may provide better understanding of this high-risk population.