SESSION TITLE: Cardiovascular Disease as a Comorbidity SESSION TYPE: Original Investigations PRESENTED ON: 10/23/2019 10:45 AM - 11:45 AM PURPOSE: Asthma immunopathology is complex, but is often attributed to T-helper 2 (Th2) Cell mediated inflammation. There is evidence to suggest that Th2 responses (including interleukins 4 and 5) are protective against atherosclerosis and myocardial infarction (MI). Additionally, other mechanisms involved in the pathogenesis of asthma (e.g. Interleukin 17) may protect against adverse cardiac remodeling after MI. We hypothesized that the immune profile associated with asthma may confer protection after MI. METHODS: Using the 2016 National Inpatient Sample, we identified all admissions for MI (STEMI and NSTEMI) as the primary diagnosis (ICD10 code: I21.0x-I21.4x) with or without asthma (ICD 10: J45.xx). Outcome was inpatient death. Propensity score matching (1:1) including 34 patient variables was performed using ‘nearest neighbor matching’ in MatchIt package in R. RESULTS: A total of 12,926 patients were included (6,463 with asthma and 6,463 controls without asthma). Compared with controls, asthma patients were more likely to be male (42.1% vs 44.6%, P=0.005), have STEMI (18.5% vs 20%, P=0.038), and percutaneous coronary intervention (39.6% vs 41.6%, P=0.019), lower prevalence of cancer (3.8% vs 3%, P=0.015), and slightly lower Elixhauser Score (10 [5-17] vs 9 [3-15], P=0.017), and Charlson Comorbidity Index (3 [2-6] vs 3 [3-5], P=0.001), but no difference in age, race, hypertension, dyslipidemia, diabetes, smoking, drug use, HIV, anemia, peripheral vascular disease, chronic kidney disease, depression, atrial arrhythmias, admission month, weekend admission, or elective admission (P=NS for all). Inpatient mortality was lower in patients with asthma vs controls (odds ratio 0.74 [0.62-0.89], P=0.001), which remained unchanged after further adjusting for sex, STEMI, PCI, cancer, Charlson and Elixhauser indices (OR 0.80 [0.66-0.97], P=0.025). There was no interaction between asthma and sex (P=0.33) or type of MI (P=0.69) with respect to mortality. There was no difference in length of stay (4 [2-7] vs 4 [2-7] days, P=0.82) or total inpatient charges (36,513 [17,453-70,616] vs 36,259 [16,759-69,112] USD, P=0.34) between control and asthma. CONCLUSIONS: In this large national, propensity-score matched cohort, asthma seems to be associated with lower mortality in patient admitted with myocardial infarction. Further studies are needed to identify the mechanisms underlying this observation. CLINICAL IMPLICATIONS: Understanding the immunopathology of asthma may provide mechanistic clues to improve outcomes in patients with myocardial infarction. DISCLOSURES: No relevant relationships by Sadeer Al-Kindi, source=Web Response No relevant relationships by Mohamed Khayata, source=Web Response No relevant relationships by nour tashtish, source=Web Response No relevant relationships by Zaid Yaqoob, source=Web Response No relevant relationships by Joe Zein, source=Web Response Research Grant relationship with Astrazeneca Please note: >$100000 Added 03/15/2019 by David Zidar, source=Web Response, value=Grant/Research Honorarium for education relationship with Medtronic Please note: $5001 - $20000 Added 03/15/2019 by David Zidar, source=Web Response, value=Honoraria Research funding relationship with NIH Please note: $20001 - $100000 Added 03/15/2019 by David Zidar, source=Web Response, value=Grant/Research Support Removed 03/15/2019 by David Zidar, source=Web Response Research Funds relationship with NIH Please note: >$100000 Added 03/15/2019 by David Zidar, source=Web Response, value=Grant/Research Support