FRI108 Role Of Obesity In Patients With Coronary Artery Dissection

Abstract

Abstract Disclosure: S. Karki: None. V. Deenadayalan: None. S. Shoura: None. R. Gajjar: None. A. Shahi: None. Background: Coronary artery dissection (CAD) is an established cause of acute coronary syndrome (ACS) in the general population. However, its risk factors and pathophysiology remain poorly understood. We aim to compare the clinical outcomes in patients admitted for CAD with and without obesity. Methods: This was a trend study of the National Inpatient database from 2010 to 2019. Adult patients (age >18) with a principal diagnosis of APE were identified using the International Classification of Diseases code, tenth revision (ICD-10), and were divided into two groups based on a secondary diagnosis of Morbid Obesity (MO). Primary outcomes evaluated were in-patient mortality, Length Of Stay (LOS) and Total Hospitalization Charges (THC). Secondary outcomes included acute severity measures like blood transfusion, Intensive Care Unit (ICU) admission, Cerebrovascular Accidents (CVA), and Acute Kidney Injury (AKI). Multivariate linear and logistic regression were used to adjust for confounders. We estimated trends, inpatient mortality, mean length of hospital stays (LOS) and mean total hospital charges (THC) over the period. Multivariable regression analysis adjusted for age and sex was used to obtain trend statistics on outcomes. Results: Out of 2,440 adult patients admitted with CAD, 440(18%) were found to be obese. The mean age in obese group vs non-obese was 52.8 and 55.9 years respectively. There was a trend towards an increased inpatient mortality among obese patients compared to non-obese with aOR 2.36 (95% CI 0.73-7.59, p=0.148) however, this did not reach statistical significance. Similarly, there was no statistically significant difference in terms of LOS and THC. Among secondary outcomes, the rate of blood transfusion (11.3% vs 4.7%, aOR 1.97, 95% CI 0.77-5.04), AKI (15.9% vs 9.7%, aOR 1.23, 95%CI 0.58-2.65) and CVA (2.2% vs 1.5%, aOR 0.43, 95% CI 0.03-7.58) seemed to be increased in obese group. Odds of ICU admission was similar between both the groups (10.2 % vs 10.5%, aOR 0.75, 95% CI 0.33-1.68). Conclusion: Obesity does not significantly increase the in-patient mortality and other secondary outcomes among patients admitted for CAD which is reassuring. Future studies looking into the pathophysiology behind this phenomenon are needed. Presentation: Friday, June 16, 2023