PO-05-164 IMPACT OF ARRHYTHMIAS IN PATIENTS WITH HEMOCHROMATOSIS: A NATIONAL INPATIENT SAMPLE (NIS) ANALYSIS

Abstract

Hemochromatosis is a relatively rare genetic disease that results in restrictive cardiomyopathy caused by the deposition of iron. Iron has a higher affinity to deposit in the conduction system of the heart resulting in a lower threshold for developing arrhythmias. We sought to assess the data on the burden of arrhythmias in hospitalized patients with hemochromatosis. To study the impact of arrythmia in a special study cohort i.e. adults with hemochromatosis The national inpatient sample (NIS) from 2018-2020 was queried for adult patients (age>18 yrs) admitted with a secondary diagnosis of hemochromatosis. These patients were stratified for arrhythmias [atrial fibrillation (AF), atrial flutters, SVTs, heart blocks (first degree, second degree, complete heart blocks [CHB], ventricular tachycardia (VT), and fibrillation(VF)]. Baseline risk factors and cardiac complications were compared. Multiple regression analysis was performed using mortality as the primary outcome. Results were further validated with propensity-matched analysis. A total of 141755 adult patients hospitalized from 2018-2020 had hemochromatosis with a mean age of 55 years. Of these, 33.84% were females and 16.59% had an underlying arrhythmia. In the cohort of hemochromatosis, patients with concurrent arrhythmias had a higher prevalence of diabetes mellitus (27.67% vs 18.55%; P<0.0001), hyperlipidemia (41.08% vs 22.83%; P<0.0002), tobacco abuse (30.5% vs 24.05%; P<0.0001) and obesity than those without arrhythmias (14.77% vs 10.98%; P<0.0001). The prevalence of valvular abnormalities (36.39% vs 24.55%; P<0.0001), old myocardial infarction (6.91% vs 3.25%; P<0.0001), and coronary artery disease (28.06% vs 10.68%; P< 0.0001) was also significantly higher in these patients. Multivariate regression analysis revealed higher odds of mortality with AF, VF, and VT in adult patients with hemochromatosis (Table 1). Propensity-matched analysis confirmed these findings. (Table 2) The odds of mortality were not significant with CHB in these patients. Hemochromatosis portends worse outcomes with arrhythmias compared to without it. Arrhythmias in hemochromatosis should be better managed to improve patient outcomes. Further studies are warranted to determine the pathogenesis of arrhythmias in patients with hemochromatosis to develop therapeutics and mitigate complications.