Risultati per: Long COVID: principali risultati, meccanismi e raccomandazioni

Circulation, Volume 150, Issue Suppl_1, Page A4146081-A4146081, November 12, 2024. Background:Long QT Syndrome (LQTS) is an inherited arrhythmia syndrome that predisposes patients to sudden death. Prior studies on racial disparities in LQTS have shown similar number of cardiac events, but longer QTc in Black patients compared to non-Hispanic Whites (NHW). There is limited data on cardiac events in Hispanic children with LQTS. We hypothesized that Hispanic children with LQTS have worse outcomes compared to NHW children.Methods:This retrospective cohort study of the Pediatric Health Information System (PHIS) database included children ages 0 – 17 years hospitalized from 2013-2024 with an International Classification of Disease 9thor 10thedition code for LQTS listed in the first five admission diagnoses. Patients with congenital heart disease and chromosomal abnormalities were excluded. The primary predictor variable was race/ethnicity, with covariables including age, sex, and insurance type. Our primary outcome variable was a documented lethal arrhythmia, and secondary outcomes included pacemaker and/or implantable cardioverter defibrillator (ICD) placement. Chi-square was used to assess patient characteristics. Univariable mixed-effect log-binomial regression was used to assess risk of outcomes by characteristics using hospital as a random effect with multivariable models generated via backward elimination.Results:We identified 6,476 children (24% Hispanic, 76% NHW). Compared to NHW children, Hispanic children were more often male and presented earlier (median age 11y vs 13y, 25-75 IQR 6-15; p

Circulation, Volume 150, Issue Suppl_1, Page A4141859-A4141859, November 12, 2024. Background:Field activation of patients with ST-segment elevation myocardial infarction (STEMI) by Emergency Medical Services (EMS) during the COVID-19 (COVID) pandemic era involved a change in policy whereby patients underwent COVID-19 testing in the emergency department (ED) prior to Percutaneous Coronary Intervention (PCI) versus bypassing the ED to the Catheterization (Cath) Lab.Research Question:We aimed to compare In-Hospital Mortality and other performance metrics of field activated STEMI patients at a large rural health system during the COVID era to pre and post pandemic periods.Methods:Retrospective single-center (Essentia Health, Duluth, MN, USA) cohort study of consecutive patients with STEMI activation identified in the field by EMS prior to the COVID era (5/27/2018–3/26/2020), during the 22 months of the COVID testing policy (3/27/2020–1/25/2022), and post-COVID when ED bypass resumed (1/ 26/2022–11/26/2023). The main outcomes of this study were in-hospital mortality and common STEMI system performance metrics.Results:A total of 373 consecutive field activated STEMI cases were included (pre COVID [N =132], COVID [N = 104], post COVID [N = 137]). Pre COVID, 40.9% of EMS activated STEMI cases stopped in the ED prior to the Cath Lab, 97.1% during the COVID era, and 51.1% in the post-COVID era (p

Circulation, Volume 150, Issue Suppl_1, Page A4143723-A4143723, November 12, 2024. Introduction:Thrombocytosis, sometimes extreme, after acute Kawasaki disease (KD) is common and felt to be pathognomonic of this diagnosis, although has also been reported after multisystem inflammatory syndrome in children (MIS-C), a clinically similar condition. We sought to determine differences in factors associated with thrombocytosis for each condition.Methods:From 01/2020 to 10/2023 across 41 sites in 8 countries from the International KD Registry, 1674 MIS-C and 1290 contemporaneous KD patients with adequate laboratory data were included in the analysis. Age-related cutpoints (derived from the CALIPER Study of normal children/adolescents; AJCP 2020; 154:342) were applied to peak platelet counts to define thrombocytosis (age 647 x109/L; age 1 to 434; age 12 to 371). Associations of demographic, clinical, laboratory and outcome factors with thrombocytosis were determined for each diagnosis group.Results:Thrombocytosis was more prevalent after KD (57%) than MIS-C (49%; p

Circulation, Volume 150, Issue Suppl_1, Page A4144377-A4144377, November 12, 2024. Mammalian cells have several adaptive mechanisms to counteract the adverse effects of metabolic and redox stress induced by ischemia. Hypoxia, a hallmark of ischemia, results in the selective reduction of the tricarboxylic acid cycle metabolite, α-ketoglutarate, to theL-(S)-enantiomer of 2-hydroxyglutarate (L2HG) in several cell types. L2HG protects hypoxic cells by buffering increases in the NADH/NAD+redox couple and inhibiting mitochondrial electron transport. In addition, the accumulation of L2HG induced by genetic knockout of L2HG dehydrogenase (L2HGDH), the only known enzyme capable of oxidizing L2HG back to α-ketoglutarate, protects mice against myocardial injury during ischemia. This protection by L2HG manifests as decreased myocardial infarct size and improved cardiac function, owing partly to a metabolic shift in carbon flux from glycolysis towards the pentose phosphate pathway. However, myocardial ischemia also leads to perturbations in fatty acid metabolism as manifest by accumulation of acylcarnitines and acyl-CoA’s. It remains unclear as to whether or not L2HG accumulation affects fatty acid metabolic homeostasis during myocardial ischemia. Here, we induced L2HG accumulation by homozygous deletion of thel2hgdhgene in male mice (l2hgdh-/-; n=12). Hearts isolated from these mice and their wild-type littermates (l2hgdh+/+; n=13) were subjected toex vivoLangendorff perfusion at coronary perfusion pressure of 80 mmHg for 30 min with (ischemic group) or without (control group) subsequent perfusion at ~10% pressure for 90 min. Using liquid chromatography tandem mass spectrometry (LC-MS/MS)-based nontargeted lipidomics, we identified several species of long chain acylcarnitines that accumulated by ischemia in hearts obtained fromL2HGDH+/+mice [linoleoyl carnitine, palmitoyl carnitine, and hydroxy-linoleoyl carnitine increased by 13.2-fold (p=4.2 x 10-6), 10.7-fold (p=1.7 x 10-6), and 10.0-fold (p=5.8 x 10-6), respectively]. Interestingly, however, this accumulation was attenuated substantially in ischemic hearts obtained fromL2HGDH-/-mice [hydroxy-linoleoyl carnitine, palmitoyl carnitine, and linoleoyl carnitine were downregulated by 62.6% (p=0.034), 54.2% (p=0.018), and 35.4% (p=0.054) in ischemic hearts fromL2HGDH-/-mice when compared toL2HGD+/+littermates]. Overall, these findings highlight a novel and potentially important role for L2HG in restoring the perturbations in fatty acid metabolism induced by myocardial ischemia.

Circulation, Volume 150, Issue Suppl_1, Page A4141946-A4141946, November 12, 2024. INTRODUCTION:Mechanisms contributing to the post-acute sequelae of SARS-CoV-2 (PASC, aka Long COVID) and associated functional limitations are unclear.RESEARCH QUESTION:Determine cardiovascular, autonomic and exercise physiology among patients with Long COVID.METHODS:Twenty-one Long COVID patients (16 females, 41±12yrs) underwent cardiovascular assessment during head-up tilt at supine, 30oand 60o, a 10-minute upright standing orthostatic challenge and cardiopulmonary exercise testing (CPET). Baroreceptor sensitivity was determined with Valsalva maneuver. Heart rate (HR) and blood pressure (BP) were monitored continuously. Plasma norepinephrine (NE) was monitored during tilt.RESULTS:During tilt, HR increased with transition from supine to 30oand 60o(72±12 v. 80±14 v. 90±15bpm, P

Circulation, Volume 150, Issue Suppl_1, Page A4141165-A4141165, November 12, 2024. Background:Current evidence supports the use of the Ross procedure (pulmonary autograft) in adults with aortic valve disease.Aims:To examine the ten-year clinical and echocardiographic outcomes following the Ross procedure using a tailored approach.Methods:This prospective cohort included 455 consecutive adults (333 male [73.1%]) with a median age of 50.0 years (IQR, 40.0-57.0) undergoing a Ross procedure at a single center. Patients with aortic aneurysms (37.4%), previous cardiac surgery (15.2%) and active endocarditis (5.7%) were included. The predominant lesion was aortic stenosis (AS) in 379 patients (83.3%) and aortic insufficiency (AI) in 76 patients (16.7%). The study period ranged from February 1, 2011, to December 31, 2019. Primary endpoints were cumulative incidence of any, autograft, or homograft reintervention, and time-related valve function (AI grades 0-4). The secondary endpoint was ten-year survival among Ross patients compared with that in the age- and sex-matched Canadian population. Median clinical follow-up was 6.0 years (maximum 13 years). Follow-up was 90% complete for clinical and 87% complete for echo follow-up.Results:Operative mortality was 0.4% (n=2). Both patients were operated among the first 100 cases. At 10 years, cumulative incidence of any aortic and/or pulmonary reintervention was 5.0% (95% CI, 2.3-9.4%); autograft reintervention 1.5% (0.5-3.4%); and homograft reintervention 3.4% (1.9-5.7%). In patients with preoperative AS, cumulative incidence of autograft reintervention was 1.8% at 10 years (0.6-4.1%), versus 0% in patients with preoperative AI (p=0.6) (Figure 1). At 10 years, cumulative incidence of AI grade >2 was 2.0% (0.9-4.2%), and did not differ between patients with preoperative AS or AI (p=0.9) (Figure 1). Ten-year survival was 96.5% (95% CI, 94.7-98.7%), translating to a relative survival of 100% (99.4-100%) compared to the matched general population.Conclusion:This study demonstrates that using a tailored surgical approach and contemporary perioperative management strategies, the Ross procedure is associated with excellent long-term valve function and freedom from reintervention in an all-comer adult patient population. Moreover, it translates into restored late survival, mimicking the general population. These results further support the notion that, in reference centers, the Ross procedure should be considered in adults needing valve replacement.

Circulation, Volume 150, Issue Suppl_1, Page A4141811-A4141811, November 12, 2024. Background:Ambulatory ECG (AECG) enables heart rhythm monitoring during daily activities, with a focus on arrythmia detection. Detection and quantification of sleep and activity patterns during monitoring may provide insights into lifestyle and aid in contextualizing arrhythmia events.Aims:We developed an AI algorithm to classify sleep, activity, and inactivity periods using a novel AECG patch with embedded accelerometry. We assessed algorithm performance and compared it to FDA-cleared actigraphy and consumer devices, which have shown 93-99% sensitivity (SE) and 39-54% specificity (SP) in classifying sleep vs. polysomnography (PSG).Methods:We conducted a prospective study of 81 participants at 3 sites who wore the Zio®monitor AECG patch (iRhythm Technologies, San Francisco, CA) and Actigraph wGT3X (Pensacola, FL) simultaneously for 14 days. Sleep disordered breathing was excluded. Participants underwent a 6-minute walk test at the beginning of wear and in-clinic overnight PSG sleep testing at 7±3 days.Data were split into training (n=40) and validation (n=41) sets. Feature and model selection utilized five-fold cross-validation on the training set, focusing on total activity and body angle. The final machine model was trained on selected features using the entire training set. In validation, SE and SP for sleep were assessed based on 1-minute epochs vs. PSG and also vs. a 24-hour reference (combined PSG and actigraphy-wake labeling). SE and SP for activity were assessed vs. actigraphy over 8 minutes sampled per subject (4min walk test, 4min PSG wake periods).Results:The study population was diverse (age 43±14 years, 57% female, 64% White, 25% Black, 20% Hispanic). In the validation set, average sleep and wake times were 5.9 and 1.2 hours, respectively, during PSG. SE and SP were 88.8% and 54.0%, respectively, in sleep detection vs. PSG, or 88.8% SE and 95.6% SP vs. the 24-hour reference (Table 1). SE and SP for activity detection were 97.0% and 100%, respectively.Conclusion:Assessment of sleep and activity during AECG is feasible, with performance comparable to FDA-cleared actigraphy. This feature offers insights into patient wellness patterns, highlighting its potential for personalized healthcare monitoring.

Circulation, Volume 150, Issue Suppl_1, Page A4128187-A4128187, November 12, 2024. Background:Minority patients are disproportionately affected by heart failure. Therefore, we aimed to determine the impact of race on health-related quality of life in three groups of older patients (60-80 years) with heart failure who underwent advanced surgical therapies (within race and by surgery group): (1) heart transplantation (HT, with pre-transplant mechanical circulatory support [HT MCS]), (2) HT without pre-transplant MCS (HT Non-MCS), or (3) long-term MCS, if ineligible for HT.Methods:Secondary analyses were conducted using data from the Sustaining Quality of Life of the Aged: Heart Transplant or Mechanical Support study. From 10/1/15 to 12/31/18, 396 patients with heart failure were recruited at 13 U.S. medical centers, of which 305 patients underwent HT (n=161 [68 HT MCS and 93 HT Non-MCS]) or long-term MCS (n=144) and had data through 1 year follow-up. Analysis included non-inferiority testing (Long-term MCS vs HT MCS; Long-term MCS vs HT Non-MCS). To demonstrate non-inferiority, the surgical strategies by race needed to show a difference of at least 5 percentage points, with a 95% lower confidence boundary and a two-tailed p-value

Circulation, Volume 150, Issue Suppl_1, Page A4136632-A4136632, November 12, 2024. Background:The impact of postoperative atrial fibrillation (POAF) after coronary artery bypass grafting (CABG) on long-term clinical outcomes has not been adequately evaluated yet.Methods:Among consecutive 14927 patients who underwent their first coronary revascularization in the CREDO-Kyoto PCI/CABG Registry Cohort-3 (2011-2013), the study population consisted of 1483 patients who underwent CABG after excluding those with prior AF. POAF was defined as newly documented AF during hospitalization for CABG. The primary outcome measure was all-cause death after discharge. The median clinical follow-up was 5.7 (interquartile range, 4.4-6.6) years.Results:POAF was observed in 337 patients (23%). Multivariable logistic regression analysis indicated that age >=75 years (odds ratio [OR], 1.61; 95% confidence interval [CI], 1.24-2.10; P

Circulation, Volume 150, Issue Suppl_1, Page A4139661-A4139661, November 12, 2024. Introduction:Troponin-defined myocardial injury or N-terminal pro-B-type natriuretic peptide (NT-proBNP) elevation frequently coincides with coronavirus disease 2019 (COVID-19). Our prior study (COVID-MI Registry Cohort-1) confirmed that high-sensitive troponin I (HsTnI) and NT-proBNP effectively stratified mortality risk. However, variants of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) change rapidly, and it remains unclear whether these biomarkers are consistently effective in predicting prognosis of COVID-19 patients irrespective of epidemic periods.Research Questions:Can HsTnI or NT-proBNP stratify mortality risk in recent COVID-19 cohorts?Aims:To assess the potential of HsTnI and NT-proBNP levels for risk stratification in the recent COVID-19 waves.Methods:In the COVID-MI Registry Cohort-2, we enrolled 1115 consecutive COVID-19 patients admitted between October 2021 and October 2022, during the Omicron variant endemic. We collected data of HsTnI or NT-proBNP levels from hospital charts or using the samples in our hospital’s serum/plasma bank if the data were not available. The primary outcome measure was all-cause mortality.Results:On admission, more than one-third of patients were classified as having severe COVID-19. HsTnI and NT-proBNP levels were available for 427 and 414 patients, respectively. The median HsTnI and NT-proBNP levels were 16 (interquartile range [IQR]: 5-57) ng/L and 524 (IQR: 140-2056) pg/mL, respectively. We stratified the patients into three groups by HsTnI level:

Circulation, Volume 150, Issue Suppl_1, Page A4141937-A4141937, November 12, 2024. Background:Although sucrose non-fermenting 1-related kinase (SNRK) in endothelial cells (EC) has a critical role in anti-inflammation and anti-fibrosis in the kidney, whether SNRK controls EC senescence and vascular aging, and how SNRK is regulated have never been studied. Long noncoding RNAs (lncRNAs) are involved in endothelial function and are altered during aging and in response to various senescence stimuli. However, whether lncRNA controls SNRK protein levels, which regulate EC senescence and cardiovascular diseases (CVD), is still poorly understood.Methods:Immunohistochemistry was performed on mouse aortic samples. RNA fluorescence in situ hybridization (RNA-FISH) staining was taken with young and aged arteries. Young and senescent primary human ECs were used for molecular signaling analysis, and SNRK expression was manipulated using plasmid overexpression and depletion. Senescence-associated β-galactosidase (SA-β-gal) staining was performedin vitro andin vivo.Results:Analyzing the expression of senescence-associated lncRNAs by qRT-PCR in human endothelial cells, we identified a long noncoding antisense (AS) transcript of SNRK, SNRKAS, which was upregulated by forkhead box A2 (FOXA2) activation in senescent human ECin vitroand EC from aged human vesselsin vivo. SNRKAS, acting in a cis-regulatory manner, downregulated SNRK expression via RNA-mRNA interaction in EC. The passaging of primary EC and X-ray irradiation (XRI) substantially decreased SNRK protein levels, while elevating SNRKAS levels; SNRK overexpression reversed XRI-induced protein and mRNA upregulation of p16, a cellular senescence marker. Furthermore, SNRK was required for the expression of lamin B1, while negatively regulating the stimulator of interferon genes (STING) signaling in EC. Finally, endothelial SNRK deficiency in mice promoted endothelial senescence, aortic stiffness, and atherogenesisin vivo.Conclusions:We conclude that lncRNA SNRKAS acts as a negative regulator of endothelial senescence via downregulation of SNRK.

Circulation, Volume 150, Issue Suppl_1, Page A4139675-A4139675, November 12, 2024. Background:The net benefit of aspirin cessation in older adults remains uncertain. This study aimed to use observational data to emulate a randomized trial of aspirin cessation versus continuation in older adults without cardiovascular disease (CVD).Methods:Post-hoc analysis using a target trial emulation framework (Table 1) applied to the immediate post-trial period (2017-2021) of a study of low-dose aspirin initiation in 19,114 adults aged 70 years and older (ASPREE; NCT01038583). Participants from Australia and US were included if they were free of CVD at the start of the post-trial intervention period (time zero, T0) and had been taking open-label or randomized aspirin immediately before T0 (Fig 1A). The two groups in the target trial were: aspirin cessation (participants who were taking randomized aspirin immediately before T0; assumed to have stopped at T0 as instructed) versus aspirin continuation (participants on open-label aspirin at T0 regardless of their randomized treatment; assumed to have continued at T0). The outcomes after T0 were incident CVD, major adverse cardiovascular events (MACE), all-cause mortality, and major bleeding during 3, 6, and 12 months (short-term), and 48 months (long-term) follow-up. Hazard ratios (HRs) comparing aspirin cessation to continuation were estimated from propensity-score (PS) adjusted Cox proportional-hazards regression models.Results:We included 6,103 CVD-free participants (cessation: 5,427, continuation: 676). Participant selection flow chart is presented inFig 1B. Over both short- and long-term follow-up, aspirin cessation versus continuation was not associated with elevated risk of CVD, MACE and all-cause mortality (HRs, at 3 and 48 months respectively were, 1.23 and 0.73 for CVD; 1.11 and 0.84 for MACE; 0.23 and 0.79 for all-cause mortality, p >0.05) but cessation had a reduced risk of incident major bleeding events (HRs at 3 and 48 months, 0.16 and 0.63, p

Circulation, Volume 150, Issue Suppl_1, Page A4144303-A4144303, November 12, 2024. Background:Higher blood-pressure variability (BPV) across multiple visits has been associated with greater risk for mortality and adverse cardiovascular and neurocognitive outcomes. However, no studies have examined associations of BPV with sudden cardiac death (SCD), a leading mechanism of death among adults.Methods:We used individual-level participant (ppt) data from 5 cohorts that are included in the LRPP dataset, (CARDIA, ARIC, Framingham Original and Offspring, and CHS), using baseline visits from the 1980s-2000s. We included ppts aged 40-80 years with at least 3 blood pressure (BP) measurements. Visit-to-visit BPV was quantified over 15 years using the standard deviation (SD) across all visits or the average real variability (ARV; average absolute difference between successive BP measurements, also taking the order of the BP measurements into account). SCD was adjudicated by each cohort using standardized definitions. Cox models (adjusted for covariates) were assessed to examine associations of BPV measures with SCD.Results:There were 23,499 ppts (mean age 52.7±8.7 years, 55.3% women, 16.9% Black) followed for 15 years for BPV data and then for 10.3±6.6 years for SCD; 484 ppts (2.1%) experienced SCD. The mean SD and ARV were 11.1±6.3 and 11.9±7.3 mm Hg for systolic BP, 6.4±3.5 and 7.0±4.0 mm Hg for diastolic BP, and 7.0±3.9 and 7.8±4.6 mmHg for mean arterial pressure (MAP), respectively. After adjustment for age, sex, and race, each 1 mm Hg greater SD or ARV in MAP was associated with 9% (95% CI, 7-11%) or 6% (95% CI, 5-8%) higher hazards for SCD, respectively (Table). Associations of BPV with SCD were partially attenuated but remained significant after adjustment for other risk factors, baseline BP, and change in BP from baseline to end of observation. The pattern of results was overall similar for MAP, systolic BP, and diastolic BP. Ppts in the highest vs lowest quartiles of BPV were at approximately 50% higher adjusted risk for SCD (Table).Conclusions:Long-term BPV in middle age is associated with SCD, even after adjusting for underlying BP change with age and other risk factors. BPV may be useful as a marker to identify individuals in the general population at higher risk for sudden death.

Circulation, Volume 150, Issue Suppl_1, Page A4143784-A4143784, November 12, 2024. Background:Hypertension is the leading preventable risk factor for cardiovascular disease (CVD) and all-cause mortality worldwide. Community health worker (CHW)-led intervention has been effective in lowering blood pressure (BP) and CVD risk. However, the long-term effectiveness of CHW-led intervention is unknown.Aim:We assessed the long-term effectiveness of a CHW-led intensive BP intervention on CVD incidence and all-cause mortality.Methods:The China Rural Hypertension Control Project (CRHCP) involved 33,995 hypertensive individuals aged ≥40 years from 326 villages in rural China. A total of 163 villages were randomly assigned to a CHW-led intervention, while the other 163 villages were assigned to usual care. CHWs were trained village doctors who initiated and titrated antihypertensive medications using a simple stepped-care protocol according to ACC/AHA clinical guidelines. They also conducted health coaching and delivered free or discounted antihypertensive medications to participants. The primary effectiveness outcome was a composite of myocardial infarction, stroke, heart failure, or CVD death during the 48-month follow-up period. Secondary outcomes included CVD death and all-cause death. Safety outcomes were also assessed at 48 months.Results:During a median follow-up of 48 months, 1,744 CVD events (2.6% per year) were documented in the intervention group, compared to 2,191 CVD events (3.5% per year) in the usual care group. The CHW-led intervention resulted in a 27% reduction in CVD (hazard ratio [HR] 0.73; 95% CI 0.69 to 0.78). Furthermore, CVD deaths were reduced by 24% (HR 0.76; 95% CI 0.68 to 0.84), and all-cause deaths were reduced by 14% (HR 0.86; 95% CI 0.80 to 0.94) in the intervention group compared to the usual care group. Participants in the intervention group had a significantly lower rate of serious adverse events compared to usual care participants (risk ratio 0.94; 95% CI: 0.91 to 0.98). However, there was no statistically significant difference in injurious falls, symptomatic hypotension, or syncope between the two groups.Conclusion:This randomized cluster trial showed that a CHW-led intervention significantly reduced CVD risk and all-cause mortality over 48 months among rural residents in China. This feasible and effective BP intervention strategy should be scaled up in China and other low- and middle-income countries to reduce the burden of CVD worldwide.

Circulation, Volume 150, Issue Suppl_1, Page A4134957-A4134957, November 12, 2024. Background:Dilated cardiomyopathy (DCM) is the most common cause of pediatric heart failure (HF), but there is limited literature on its long-term prognosis and treatment outcomes. We examined risk factors for long-term morbidity and mortality and outcomes of care in childhood-onset DCM.Methods:Electronic medical records from a tertiary care pediatric hospital (SickKids, Toronto, Canada) were used to retrospectively follow children ages 0–18 years with DCM from January 1, 2001 to July 1, 2017. Provincial healthcare administrative data was used to monitor outcomes recorded outside of SickKids, following patients during the same time period and into adulthood (age >18 years) until August 31, 2023. We compared DCM cases, with or without echocardiographic recovery (LVEDD z score < 2 and LVEF ≥ 55%), and controls matched on sex, age, and urban/rural residence on a range of health and health service outcomes. Primary outcomes included all-cause mortality, heart transplant (HT), and inpatient admission for HF. Among cases, Cox proportional hazards regression with backwards selection was used to identify demographic, disease, and treatment characteristics associated with each primary outcome, with candidate variables selected based on univariate analysis and clinical judgment.Results:We studied 156 patients with DCM and 780 controls for a median of 14.8 years. Median age at the end of follow-up was 16.2 years. Compared with controls, DCM cases had higher rates of all-cause death, HT, and HF admission (allP

Circulation, Volume 150, Issue Suppl_1, Page A4145353-A4145353, November 12, 2024. Background:Myocardial injury complicating percutaneous coronary intervention (PCI) is associated with mortality, but sex differences in outcomes are uncertain. We explored sex differences in the incidence and long-term outcomes of post-PCI myocardial injury (PPMI).Methods:Adults who underwent PCI at NYU between 2011-2020 were included in this retrospective analysis. Patients with ACS as the indication for PCI were excluded. PPMI was defined as a peak CKMB concentration >99% of the upper reference limit. The incidence of PPMI by sex was compared by Chi-square tests. Independent predictors of elevated CKMB post-PCI were evaluated with linear regression models in subgroups by sex. Cox proportional hazard models were generated to evaluate relationships between PPMI and all-cause mortality by sex.Results:Of 10,807 adults undergoing PCI, 24.9% (2,694) were female. Females were older than males at the time of PCI (68.9 vs. 65.8, p