Risultati per: Sindromi coronariche acute

Circulation, Volume 150, Issue Suppl_1, Page A4134267-A4134267, November 12, 2024. Background:The effects of glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium–glucose cotransporter 2 inhibitors (SGLT2is) on reducing cardiovascular events in heart failure patients are well-established; however, less is known about their effects after a myocardial infarction. This study aims to investigate the effects of GLP-1RAs and SGLT2is on in-hospital mortality and 30-day readmission in type 2 diabetic patients with/without heart failure who were hospitalized for acute coronary syndrome (ACS).Methods:We conducted a multicenter retrospective cohort on type 2 diabetic patients who were admitted to the hospital for ACS from 01/01/2020 to 01/31/2024 across 16 West Florida hospitals. Patients receiving a GLP-1RA alone, SGLT2i alone, or both were compared to those taking neither. Chi-square and binary logistic regression were used to predict the clinical outcomes of in-hospital mortality, all-cause readmission within 30 days, and cardiac readmission within 30 days.Results:Among 7,481 type 2 diabetics with ACS, 392 (5.24%) were taking GLP-1RA monotherapy, 577 (7.71%) were taking SGLT2i monotherapy, 144 (1.92%) were taking both, and 6,362 (85.12%) were taking neither. The likelihood of in-hospital mortality was similar among patients on neither medication compared to patients on both (χ2= 0.06,p= 0.802), GLP-1RA monotherapy (χ2= 0.61,p= 0.435), and SGLT2i monotherapy (χ2= 0.002,p= 0.968). The odds of all-cause readmission within 30 days was similar among patients on neither medication compared to patients on both (χ2= 0.0004,p= 0.983), GLP-1RAs monotherapy (χ2= 0.07,p= 0.791), and SGLT2i monotherapy (χ2= 3.10,p= 0.078). The likelihood of cardiac readmission within 30 days was similar among patients on neither medication compared to patients on both medications (χ2= 1.63,p= 0.202), GLP-1RA monotherapy (χ2= 0.95,p= 0.329), and SGLT2i monotherapy (χ2= 0.94,p= 0.332).Conclusion:Our study found no significant differences in the odds of in-hospital mortality or 30-day readmission among type 2 diabetics with ACS who were taking GLP-1RAs, SGLT2is, or both, when compared to those taking neither. These findings further support the outcomes discovered in the EMPACT-MI trial.

Circulation, Volume 150, Issue Suppl_1, Page A4138635-A4138635, November 12, 2024. Backgrounds:Cardiac surgery associated acute kidney injury (CSA-AKI) is a prevalent and detrimental complication following cardiac surgery, with significant effects on both in-hospital and long-term morbidity and mortality. The renal protective effect of statins for patients undergoing cardiac surgery remains unclear.Purpose:This study aims to evaluate the association between perioperative statin therapy and the risk of CSA-AKI following coronary artery bypass grafting (CABG).Methods:This retrospective cohort study included consecutive patients undergoing CABG between 2013 and 2022, with one year follow-up after hospital discharge. Any usage of statin initiated from admission to 72 hours after surgery was defined as perioperative statin therapy. The primary outcome was in-hospital postoperative AKI according to the Kidney Disease: Improving Global Outcomes (KDIGO) criteria. The secondary outcomes were composite measures including all-cause mortality and dialysis at 30 days and one year. Multivariate Cox proportional hazards regression models were constructed to assess the association between perioperative statin and pre-defined outcomes.Results:Among the included 36288 patients, 22272 (61.3%) patients received perioperative statin therapy, with a total of 19683 (54.2%) patients developing CSA-AKI. For the primary outcome, perioperative statin was associated with a significantly decreased risk of CSA-AKI (52.8% vs. 56.5%; adjusted Odds Ratio [OR], 0.865 [95% CI, 0.829-0.904]; p < 0.001). Additionally, the occurrence of a composite measure including all-cause mortality and dialysis was statistically lower in patients who underwent perioperative statin therapy at 30 days (0.7% vs. 1.6%; OR, 0.485 [95% CI, 0.394-0.597]; p < 0.001), as well as at one year (adjusted Hazard Ratio [HR], 0.632 [95% CI, 0.543-0.737], p < 0.001). For the subgroup analysis, the association between perioperative statin and reduced CSA-AKI risk was greater among patients with chronic heart failure and undergoing on-pump CABG.Conclusions:Perioperative statin therapy was associated with significantly lower risks of CSA-AKI following CABG, and a composite measure including all-cause mortality and dialysis at both 30 days and one year. The preventive effect of perioperative statin was more pronounced in patients with chronic heart failure and undergoing on-pump CABG.

Circulation, Volume 150, Issue Suppl_1, Page A4142197-A4142197, November 12, 2024. Introduction:Few randomized clinical trials (RCTs) have evaluated the safety and efficacy of abbreviated Ticagrelor-based dual antiplatelet therapy (DAPT) in acute coronary syndrome (ACS); however, these RCTs were underpowered to detect differences in hard clinical outcomes.Research Question:What effect does abbreviated Ticagrelor-based DAPT have on risk of ischemic and bleeding events in ACS?Methods:A systematic search of MEDLINE, Cochrane, and Scopus databases was performed through 05/2024, for trials that compared abbreviated (≤ 3-months) versus standard 12-months Ticagrelor-based DAPT in ACS. The primary endpoint was all-cause mortality. Endpoints were measured at 12-months after DAPT initiation. Data were pooled using random-effects model. Heterogeneity was assessed via Chi-squared and Higgin’s I2test. RevMan 5.0 (Cochrane Collaboration, Oxford, United Kingdom) was utilized to perform statistical analysis.Results:Five trials were included in this analysis with 21,407 patients assessed. ULTIMATE-DAPT, T-PASS, and GLOBAL LEADERS-ACS assessed 1-month DAPT duration while TICO and TWILIGHT-ACS assessed 3-months DAPT duration. The average age was 62.7 years and 22.7% were women. Hypertension (61.7%), dyslipidemia (49.9%), diabetes (27.8%), and chronic kidney disease (12.7%) were the most common comorbidities. ACS presentations included NSTEMI (40.1%), unstable angina (35.2%), and STEMI (31.5%). Abbreviated Ticagrelor-based DAPT was associated with lower risk of all-cause mortality (RR 0.78; 95% CI 0.62-0.98, I2=0%) compared with standard duration DAPT. There was no differences between groups in cardiovascular death (RR 0.65; 95% CI 0.41-1.03, I2=0%), myocardial infarction (RR 1.04; 95% CI 0.85-1.27, I2=0%), stent thrombosis (RR 0.97; 95% CI 0.64-1.45, I2=0%), or ischemic stroke (RR 0.90; 95% CI 0.62-1.30, I2=0%). Abbreviated DAPT duration was associated with lower risk of major bleeding (RR 0.50; 95% CI 0.38-0.66, I2=46%).Conclusion:Our analysis includes the totality of randomized data evaluating the merits of abbreviated Ticagrelor-based DAPT after ACS. The salient study finding was the observed reduced risk of all-cause mortality with abbreviated DAPT approach, which was driven by reduced bleeding risk.

Circulation, Volume 150, Issue Suppl_1, Page A4144762-A4144762, November 12, 2024. Background:Each year, millions of people worldwide experience cardiovascular events, including acute myocardial infarctions (AMIs). Surviving an AMI can result in psychological sequelae, including negative illness perceptions, fear of recurrence, and perceived stress, that may interfere with survivors’ recovery, individually influencing their physical, emotional, and cognitive outcomes. Though influential, little is known about the individual relationships between these variables in persons who have experienced an AMI.Purpose: This study examined the relationships between illness perceptions, fear of recurrence, and perceived stress in AMI survivors. Also examined were predictors of fear of recurrence and perceived stress, changes in fear of recurrence over time, and effects of anxiety or depression.Methods:We used a repeated measures descriptive design to evaluate relationships with the brief illness perception questionnaire, the fear of progression questionnaire, perceived stress scale, and the depression, anxiety, and stress scale (N =171). Additionally, we examined the relationship between participant demographics and modifiable risk factors such as diet, exercise, and smoking. Our hypotheses were tested via multiple linear regression and mediation modeling.Results:Fear of recurrence was a significant mediator of the relationship between illness perceptions and perceived stress in AMI survivors [F(2,168) =43.31,R2=0.34,p

Circulation, Volume 150, Issue Suppl_1, Page A4144742-A4144742, November 12, 2024. Introduction:Although Frozen Elephant Trunk has emerged as a valuable technique in aortic arch pathology it is still burdened by a high mortality and morbidity rate due to the technical complexity and clinical and anatomical substrates.Research Questions:Evaluation of early hard outcomes in a surgical approach encompassing the following : 1) central cannulation of the right subclavian artery or the right axillary artery; 2) debranch-first approach (selective cannulation of left common carotid artery with single 8-mm dacron graft and the left subclavian artery for cerebral perfusion with single 10-mm dacron graft); 3) central venous cannulation of right atrium; 4) use of a home-made 4-branched perfusion circuit for extracorporeal circulation; 5) brachiocephalic artery clamping at 26–28°C and beginning of selective antegrade perfusion. The aortic arch is opened and the distal stent graft of the hybrid prosthesis is released into the descending thoracic aorta. The strengthened collar of the prosthesis is sutured to the aorta, and, after cannulation of the fourth lateral branch, systemic perfusion is resumed. The anastomosis between the hybrid prosthesis and sino-tubular junction is then completed and the cross-clamp is released. The prosthesis-elongated supra-aortic vessels are then termino-terminally re-anastomosed to the corresponding branches of the hybrid prosthesis.Methods:Retrospective analysis of a prospectively collected database including 167 patients referred for FET (55 %acute aortic dissections, 14.5% chronic aortic dissections, and 30.5% extended aneurysms, 67% males, 9.2% diabetes mellitus, 72% arterial hypertension, 8.2% chronic renal failure, 12% peripheral vasculopathy, 3% bicuspid aortic valve, 11.9% redo)Results:The average cardio-pulmonary bypass time, crossclamp time, cerebral and visceral perfusion time is 192, 102, 29 and 12 minutes, respectively. In-hospital mortality occurred in 16% (44% due to respiratory failure), spinal cord injury in 2.8% and stroke in 3.5% of patients.Conclusion:Debranch-first technique and cerebral protection through the trivascular perfusion strategy appear safe and effective in the treatment of complex arch pathology.

Circulation, Volume 150, Issue Suppl_1, Page A4139938-A4139938, November 12, 2024. Introduction:Stroke is the second leading cause of death worldwide and the leading cause of disability. Without a plasma biomarker care is often delayed. The brain is rich in lipids, which readily cross the blood-brain barrier, and therefore represent a target for biomarkers of stroke. The study aimed to determine the lipidomic changes in plasma in stroke patients through an untargeted and targeted analysis.Methods:A cohort of 482 patients from the INTERSTROKE study was included in the analysis. This included 241 stroke patients (120 ISCH, 121 HEM) and 241 age and sex-matched controls. A LC/MS/MS platform was used to perform a detailed lipidomic and oxylipidomic analysis of plasma. Biomarker analysis was performed using the Random Forest Classification algorithm (RFC).Results:Lipidomic analysis identified 141 lipid species and 32 oxylipins significantly altered in ISCH stroke compared to control and 167 lipid species and 34 oxylipins in HEM stroke. Between ISCH and HEM stroke there were in 87 significant lipids. There was a 141 % increase in phosphatidylserine (PS) 40:6 (p< 0.0001) in patients with HEM stroke compared to ISCH, whereas prostaglandin E2 was found to be 94% higher (p

Circulation, Volume 150, Issue Suppl_1, Page A4143199-A4143199, November 12, 2024. Introduction:Exercise is critical to cardiovascular health. However, the underlying molecular mechanisms are not well described. The Molecular Transducers of Physical Activity Consortium (MoTrPAC) seeks to create a detailed molecular map of the response to exercise. Described here is the first human cohort of MoTrPAC, enrolled prior to the COVID-19 shutdown (N=175).Methods:Healthy, sedentary adults were randomized to an 8-exercise circuit of resistance exercise (RE, N=73), a 40 minute submaximal endurance exercise bout (EE, N=65), or to non-exercising control (N=37). Blood, muscle, and adipose tissue were sampled at 4-7 time points relative to exercise, depending on tissue/modality. Samples were deep phenotyped across multiple omic domains including chromatin accessibility, transcriptomics, proteomics, phosphoproteomics, and metabolomics.Results:The cohort was 72% female, with a mean±sd age of 41±15 years and BMI of 27.1±4.0 kg/m2. Exercise affected over 34,000 molecular features in ≥1 tissue/time point including a high proportion of transcriptomic and phosphoproteomic features (Figure A). Molecular signatures were compared between EE and RE: enrichment analysis of muscle phosphoproteomics showed a greater activation of MAP kinases in RE compared to EE at all time points. To identify plausible exerkines (secreted molecules signaling an acute exercise bout), differentially abundant features in any sampled tissue cells were compared to temporally-matched cognate protein levels in plasma, yielding 110 features. A known exerkine, CX3CL1 (fractalkine) was identified, in addition to novel candidates, such as cellular communication network factor 1 (CCN1), a secreted extracellular matrix protein linked to plasma triglyceride levels, which showed increased abundance early post exercise (Figure B). Network analysis across tissues and omes identified novel transcription factor “hubs” as candidate master regulators of exercise response.Conclusions:These first MoTrPAC data represent an unparalleled multi-tissue, multi-omic, multi-time point, multi-modality map of acute exercise, enhancing our understanding of the molecular transducers that may link exercise and cardiovascular health.

Circulation, Volume 150, Issue Suppl_1, Page A4141644-A4141644, November 12, 2024. Background:Previous studies have shown conflicting results regarding higher rates of contrast-induced acute kidney injury (CI-AKI) after percutaneous coronary intervention (PCI) among women as compared to men. We sought to identify covariates that explain possible sex differences in rates of CI-AKI after PCI.Methods:This was a retrospective observational cross-sectional study of all PCIs performed at Cedars-Sinai Medical Center from 2020-2023, sourced from the National Cardiovascular Data Registry. The primary outcome and regressor were CI-AKI and sex, respectively. Covariates were other patient demographics, comorbidities, procedural factors, and health insurance. We excluded patients with pre-PCI dialysis requirement or without pre/post-PCI creatinine. We used multivariable-adjusted logistic regression to evaluate rates of CI-AKI among women versus men. Using additive adjustment, we identified factors that accounted for the sex differences.Results:Of 2971 PCIs included, 820 (27.6%) were performed in women, 316 (10.6%) in Black patients and 283 (9.5%) in Hispanic patients. On average, women were older than men (73.9 vs 68.6 years, p

Circulation, Volume 150, Issue Suppl_1, Page A4138835-A4138835, November 12, 2024. Background:Recent evidence suggests the efficacy and safety of sodium-glucose transporter 2 inhibitors (SGLT-2is) in heart failure (HF) patients. However, there still remain concerns in their use among patients with physical or cognitive frailty.Methods:West Tokyo Heart Failure (WET-HF) Registry is an ongoing prospective multicenter registry in Japan enrolling all patients who were hospitalized for acute decompensated heart failure. We retrospectively analyzed the impact of physical or cognitive frailty-related factors (FF) on the association of SGLT-2i prescription with long-term outcomes using the data of WET-HF (2018-23, n=5106). Patients without data of SGLT-2i prescription at discharge were excluded. Primary endpoint (PE) was defined as the composite of cardiac death and HF rehospitalization during 2 years after discharge.Results:At baseline 3208 of 4845 patients (66%) had FF defined by any of following 5 factors: BMI

Circulation, Volume 150, Issue Suppl_1, Page A4136033-A4136033, November 12, 2024. Background:Folic acid, a B vitamin, is essential for DNA synthesis and repair, and its role in reducing homocysteine levels has been linked to cardiovascular health. Elevated homocysteine is a risk factor for cardiovascular diseases, including acute myocardial infarction (MI) and coronary artery disease (CAD). Despite evidence suggesting that folic acid supplementation may lower homocysteine levels, its clinical benefits in reducing cardiovascular events remain unclear.Methods:A comprehensive literature search was conducted in PubMed/Medline, Google Scholar, and Cochrane Library databases for studies published from 2000 to 2024 using MeSH terms related to “folic acid,” “B vitamin,” “acute myocardial infarction,” “cardiac arrest,” “heart attack,” and “coronary heart disease.” Only randomized controlled trials (RCTs) and observational studies in English involving adult patients with acute MI or CAD were included. Exclusion criteria were applied to poor-quality studies, irrelevant outcomes, overlapping populations, and non-English texts. Data on study characteristics and patient demographics were extracted, and study quality was assessed using the RoB2 tool. Outcomes were pooled using RevMan 5.3.4 software.Results:Fourteen studies on all-cause mortality showed a risk ratio (RR) of 0.99 [95% CI: 0.94-1.04], indicating no significant difference between folic acid and control groups. Eight studies on cardiovascular mortality yielded a RR of 0.90 [95% CI: 0.82-0.99], suggesting a significant reduction in cardiovascular deaths with folic acid supplementation. Analyses of sudden death, coronary artery bypass graft (CABG) events, revascularization procedures, stroke, and recurrent MI found no significant associations with folic acid supplementation.Conclusions:High-dose folic acid supplementation appears to reduce cardiovascular mortality in post-MI patients but shows no significant impact on other clinical outcomes. This meta-analysis’s limitations include potential publication bias, heterogeneity among included studies, and variability in folic acid dosages and treatment durations. Furthermore, the lack of comprehensive homocysteine level data constrained the analysis. Future large-scale RCTs are needed to fully ascertain the therapeutic potential of folic acid supplementation in secondary prevention of cardiovascular events.

Circulation, Volume 150, Issue Suppl_1, Page A4145755-A4145755, November 12, 2024. Background:Lipid-lowering therapy plays a crucial role in the secondary prevention of coronary artery disease (CAD), particularly following acute myocardial infarction (AMI). While International Guidelines recommend the early initiation of high-intensity statins post-AMI, there remains limited insight into the patterns of lipid-lowering drug utilization across healthcare systems.Purpose:This study aims to analyze the temporal trends and influencing factors associated with the utilization of lipid-lowering therapy, with a focus on high-intensity statins, among patients hospitalized with AMI.Methods:Using data spanning 2012 to 2020 from the Japanese Registry of All Cardiac and Vascular Diseases (JROAD-DPC), including all procedures and prescriptions during hospitalization, we examined 381,046 AMI cases discharged alive from 1,091 hospitals. We defined lipid-lowering therapies as the use of statins, ezetimibe, or PCSK9 inhibitors, and high-intensity statin use based on the following dosages due to insurance limits in Japan: Atorvastatin 20 mg, Rosuvastatin 10 mg, or Pitavastatin 4 mg per day. We investigated trends in lipid-lowering drug and high-intensity statin use and examined associated factors through subcategory analysis, developing a multivariate mixed logistic regression model with each institute considered a random intercept.Results:Within the cohort (with an average age of 69.2 years and comprising 26.5% females), the proportion of patients receiving any form of lipid-lowering therapies increased from 78.0% to 88.2% between 2012 and 2020. Among these individuals, the percentage of those prescribed any statins rose from 77.8% to 85.8% over the same period. However, the utilization of high-intensity statins remained relatively low, accounting for only 31.3% of cases in 2020 (Figure). In subgroup analyses, the usage of high-intensity statins was notably lower among females (26.8%) compared to males (32.9%) in 2020 (p

Circulation, Volume 150, Issue Suppl_1, Page A4144767-A4144767, November 12, 2024. Background:The efficacy of beta-blockers (BB) in patients with heart failure and reduced ejection fraction (EF) is well established. In fact, current guidelines widely recommend BB use after myocardial infarction (MI). However, the effects of long-term BB therapy in patients with acute myocardial infarction (AMI) and preserved EF remains uncertain.Hypothesis:The use of BB after AMI improves long-term outcomes in patients with preserved EF.Aims:To compare the long-term effects of BB with non-BB post AMI in patients with preserved EF.Methods:PubMed, Embase, and Cochrane Library were systematically searched from inception to May 2024 to identify studies comparing BB with no BB use after AMI in patients with preserved EF ( >50%), with a minimum follow-up of 1 year. We pooled hazard ratios (HR) with 95% confidence intervals (CI) to preserve time-to-event data in the pooled analysis. Statistical analyses were performed using R software version 4.3.1.Results:We included two randomized controlled trials and eight cohorts comprising 25,357 patients, of whom 47% received BB and 52% were men. Mean age of patients ranged from 58 to 66.2 years. Follow-up ranged from 1 to 5.2 years. There were no significant differences between groups in all-cause mortality (HR 0.86; 95% CI 0.68-1.08; p=0.20; Figure 1A), myocardial infarction (HR 1.02; 95% CI 0.84-1.24; p=0.86; Figure 1B), or hospitalization for heart failure (HR 1.06; 95% CI 0.78-1.43; p=0.71; Figure 1C). However, when performed a leave-one-out sensitivity analysis in all-cause mortality we saw significant results favoring the use of BB after omitting each study.Conclusion:In this meta-analysis, there were no significant differences in all-cause mortality, myocardial infarction, or hospitalization for heart failure when comparing long-term use of BB with no BB use after AMI in patients with preserved EF. Further trials are needed to clarify the role of BB in this setting.

Circulation, Volume 150, Issue Suppl_1, Page A4147067-A4147067, November 12, 2024. Background:Short-term exposure to ambient air pollution, especially particulate matter smaller than 2.5 microns in diameter (PM2.5), is associated with an increased risk of acute coronary syndrome and is identified as the leading modifiable cause of cardiovascular mortality in the long term. In this study, we set out to examine the effect of acute exposure to high levels of PM2.5(≥12 μg/m3) on long-term mortality risk of ST-elevation myocardial infarction (STEMI) patients.Methods:From June 2010 to October 2021, 1,553 patients at Liverpool Hospital in Sydney met the 4th Universal Definition of MI criteria for STEMI. The average daily maximum PM2.5was measured using publicly available land-based air quality monitors in the catchment area. Mortality risk between the two groups was compared using a Kaplan-Meier plot and further assessed using the Cox regression model.Results:915 STEMI patients presented on days with maximum PM2.5≥12 μg/m3. These patients had a significantly increased risk of late all-cause mortality with a hazard ratio of 3.08 (CI= 2.01-4.71, p

Circulation, Volume 150, Issue Suppl_1, Page A4120105-A4120105, November 12, 2024. Background and Aims:Thoracic endovascular aortic repair (TEVAR) is warranted in patients with Stanford Type-B aortic dissection who are at an increased risk of aneurysm rupture and enlargement. While studies indicate that development of post-operative acute kidney injury (AKI) (with incidence rate varying from 1.5% to 34%) may potentially worsen outcomes and increased mortality, the specific role of AKI in the postoperative period for patients undergoing TEVAR for Stanford Type-B aortic dissection remains understudied and unclear. Our meta-analysis aims to contribute valuable insights into this aspect.Methods:A comprehensive literature search spanning major bibliographic databases was conducted to retrieve studies comparing outcomes in Stanford Type-B aortic dissection patients undergoing TEVAR who developed AKI postoperatively versus those who did not. Our outcomes of interest included the risk of in-hospital mortality, stroke, and requirement for dialysis. Relative risks (RRs) were pooled from all studies using DerSimonian and Laird random-effects models in the ‘meta’ package of R software (Version: 2023.12.1+402). Statistical significance was set at p

Circulation, Volume 150, Issue Suppl_1, Page A4124005-A4124005, November 12, 2024. Background:Sex and racial differences in the outcomes of patients with acute coronary syndrome (ACS) persist and could be related to the differences in management including high-potency P2Y12 inhibitors.Aim:This study aims to examine the contribution of social determinants of health on the association between sex and racial differences in the prescription of high-potency P2Y12 inhibitor upon discharge.Methods:Patients with ACS undergoing percutaneous coronary intervention (PCI) from the American Heart Association Get With The Guidelines®–Coronary Artery Disease Registry between October 2019 to December 2022 were included. Multivariable hierarchical models were used to assess whether there are differences in high-potency P2Y12 inhibitors (i.e., ticagrelor or prasugrel) prescription at discharge adjusting for race/ethnicity, insurance, age, social vulnerability index (SVI), zip code designation, and medical history. Analyses were performed in women and men separately.Results:Among 135,153 patients with ACS who underwent PCI, 59.8% were discharged on a high-potency P2Y12 inhibitor. Compared with men, women were less likely prescribed high-potency P2Y12 inhibitor (66.9% vs 72%), and this pattern did not change during the study period (P=0.50) (Figure). There was a significant interaction between sex and race for high-potency P2Y12 inhibitor prescription (P< 0.05). Among women, the likelihood of high-potency P2Y12 inhibitors prescription was not significantly different across different race/ethnicities. However, in men, non-Hispanic Blacks and Hispanics had lower odds of high-potency P2Y12 inhibitors prescription compared with non-Hispanic Whites among men after adjusting for all covariates.Conclusions:In this large contemporary observational analysis of patients with AMI undergoing PCI, women were less likely prescribed a high-potency P2Y12 inhibitor upon discharge. Among women, the likelihood of high-potency P2Y12 inhibitors prescription was not significantly different across different race/ethnicities; however, in men, non-Hispanic Blacks and Hispanics had lower odds of high-potency P2Y12 inhibitors prescription. Further efforts should be directed to minimize these sex and racial disparities.

Circulation, Volume 150, Issue Suppl_1, Page A4144657-A4144657, November 12, 2024. Introduction:Seasonal variations, particularly cold weather, can increase the risk of acute coronary syndrome, as evidenced by various studies over the years. On the other hand, hot weather can cause dehydration, electrolyte imbalances, and thermoregulatory strain on the heart, leading to adverse cardiac events. In recent years with rising concerns about global warming, we aim to study the impact of climate changes during the summer on outcomes among people hospitalized with ACS.Methods:We used the National Inpatient Sample from 2016 to 2020 to identify young adults hospitalized with ACS using appropriate ICD-10 codes. Patients were categorized into two cohorts: summer (hospitalizations during June, July, and August) and non-summer (hospitalizations during other months). The outcomes studied were ACS hospitalizations and in-hospital mortality. Pearson chi-square tests and the Mann-Whitney U test were used for cohort comparisons.Results:Of 230,555 ACS hospitalizations, 26.2% (n=60,340) occurred during the summer months, with a median age of 40 years. White individuals had higher hospitalization rates compared to others (57.8% vs. 58%), and those from lower socioeconomic statuses had higher ACS hospitalizations in both cohorts (37.5% vs. 38.1%). Comorbidities like hypertension, diabetes, and hyperlipidemia were lower in the summer cohort (all p