Risultati per: Caratterizzazione dell'asma in base all'età di insorgenza: uno studio di coorte multi-database

Circulation, Volume 150, Issue Suppl_1, Page A4144346-A4144346, November 12, 2024. Background:Stroke is a leading cause of death globally. Atrial fibrillation (AF) is an important modifiable risk factor for stroke. Ascertaining the burden of stroke in AF, its temporal trends and demographic disparities can inform public health policy measures.AimsTo describe national temporal trends of ischemic stroke-related mortality in patients with AF and identify any differences by gender, race, ethnicity, or region.Methods:In this cross-sectional analysis we used death certificate data from the national CDC Wide-Ranging ONline Data for Epidemiologic Research (WONDER) database for adults aged 35-84 years between 1999 and 2020. We queried for both ischemic stroke and AF as contributing or underlying cause of death. Crude and age-adjusted mortality rates (AAMR) were computed for the overall population and stratified by sex, race/ethnicity, geographic region, state, and rural/urban status. Joinpoint Regression Analysis software was used for trend analysis. Average annual percentage change (APC) in AAMR were computed using log-linear regression models.ResultsA total of 32,386 ischemic-stroke related deaths occurred in patients with AF between 1999 and 2020. Overall mortality trends were stable until 2014, sharply rose between 2014 and 2017 (APC 27.6% [95% confidence interval, CI, 18.8-33.4]), slowing down between 2017 and 2020 (APC 2.48 [95% CI, -4.81-7.03]). Overall AAMR per 100,000 was higher in men (1.00 vs 0.86 in women; Figure 1); Non-Hispanic Whites (0.98 versus 0.81 in Non-Hispanic Blacks and 0.70 in Hispanics; Figure 2), individuals in the Western census region (1.07 vs 0.95 in Southern, 0.92 in Midwestern and 0.78 in Northeast regions; Figure 3) and non-metropolitan areas (1.06 versus 0.91 in metropolitan). The rate of increase in AAMR over recent years was significantly greater in Black populations.Conclusion:Stroke mortality in AF rose sharply since 2014. Our findings underscore racial and geographic differences that exist in stroke-related deaths in the US.

Circulation, Volume 150, Issue Suppl_1, Page A4134692-A4134692, November 12, 2024. Background and objectives:Data regarding readmission rates and predictors of readmission in cancer patients undergoing PCI are sparce. With the increasing survival rates and prevalence of cardiovascular complications in cancer patients, understanding the patterns and predictors of readmission in this population is paramount for optimizing their outcomes. Cancer patients pose unique clinical challenges due to their combined prothrombotic state and propensity for bleeding. We attempted to identify factors associated with readmission in cancer patients.Methods:We utilized the Nationwide Readmission Database from 2016 to 2020 and included patients more than 18 years of age with primary diagnosis of myocardial infarction(MI) who underwent percutaneous coronary intervention(PCI) and have a preexisting diagnosis of cancer. We used International Classification of Disease, Tenth Revision, Clinical Modification (ICD10 CM) codes to define MI, PCI, and cancer. The primary outcome was the 30-day readmission rate, and secondary outcomes were mortality rates, predictors of readmission, and common causes of readmission. The independent predictors of readmission were analyzed using cox regression analysis.Results:Of the 52,307 cancer patients who underwent PCI, 7,767 were readmitted within a 30-day period. The readmission rate for these patients was 15.70%. The mortality rate was 6.05% for index admission and 6.80% for readmitted cases. Among the readmitted patients in the strongest independent predictor for readmission were leaving against medical advice(AMA), anemia, congestive heart failure, and discharge to a skilled nursing facility or home health. Common causes of readmission within this time included hypertensive heart disease with concomitant CKD stage I-IV and heart failure (6.21%), sepsis (6.12%), NSTEMI (5.60%), hypertensive heart disease with concomitant heart failure (4.62%) and acute kidney injury (1.98%).Conclusions:Thirty-day readmission rate was 15.70%. Independent predictors of readmission were anemia, diabetes mellitus, congestive heart failure, malnutrition, peripheral artery disease, leaving against medical advice, and discharge to facility. Most common cause of readmission was hypertensive heart and kidney disease with heart failure, which comprised 6.21%.

Circulation, Volume 150, Issue Suppl_1, Page A4140872-A4140872, November 12, 2024. Background:Permanent Pacemaker (PPM) implantation is recognized as a class I indication treatment for patients with high-grade Atrioventricular (AV) blocks, infra-Hisian conduction blocks, and symptomatic sinus node diseases such as sinus bradycardia. There remains a scarcity of data regarding the impact of dialysis-dependent End-Stage Renal Disease (ESRD) on PPM implantation outcomes, particularly in terms of readmission rates. We aim to evaluate short-term readmissions in dialysis-dependent ESRD patients post-PPM placement, utilizing data from the National Readmission Database (NRD).Methods:The NRD for the year 2020 was used to identify dialysis-dependent ESRD adults who underwent PPM implantation, employing ICD-10 CM and PCS codes. We focused on outcomes including 30-day readmission rates, length of stay (LOS), total hospital charge (THC), and predictors of readmissions. Both multivariate and univariate logistic and linear regression analyses were employed to assess outcomes and adjust for potential confounders.Results:Out of 2,497 dialysis-dependent ESRD patients who underwent PPM implantation, 2,353 were discharged alive. Within 30 days of discharge, 540 (22.9%) patients were readmitted. Those readmitted had a longer LOS and higher comorbidity burden but were similar in age, sex, hospital characteristics, and household income status compared to those not readmitted. Readmissions incurred an additional average THC of $103,599 and an average LOS of 7.3 days. The top five causes of readmissions were hypertensive heart disease with heart failure (11.3%), sepsis (9.9%), fluid overload (2.4%), hypoglycemia without coma in type II diabetes mellitus (2.0%), and non-rheumatic aortic valve stenosis (1.7%).Conclusion:This analysis reveals that 22.9% of dialysis-dependent ESRD patients who underwent PPM implantation were readmitted within 30 days, resulting in extended LOS and increased THC. These readmissions negatively impact patient outcomes and exacerbate the burden on healthcare resources. Optimizing the management plans for this patient group is crucial to enhancing outcomes and using healthcare resources more effectively.

Circulation, Volume 150, Issue Suppl_1, Page A4147150-A4147150, November 12, 2024. Background:Coronary artery disease (CAD) in patients with hypertension is a significant health concern among adults in the United States. This study investigates trends and demographic disparities in mortality rates due to CAD in hypertensive patients aged 25 and older from 1999 to 2020.Methods:The CDC WONDER database’s mortality data from 1999 to 2020 was used for a retrospective analysis. Average Annual Percentage Change (AAPC) and Annual Percent Change (APC) were used to evaluate trends and calculate age-adjusted mortality rates (AAMRs) per 100,000 people. The year, sex, race/ethnicity, and geographic regions were used to stratify the data.Results:Between 1999 and 2020, CAD in hypertension caused 1,512,89 medical facilities, accounting for 37.9% of all deaths. With an AAPC of 1.88 (95% CI: -0.81 to 4.36, p = 0.118), the overall AAMR grew from 7.7 in 1999 to 36.0 in 2020. There was a notable increase between 1999 and 2001 (APC: 30.07, p = 0.040) and a minor growth between 2001 and 2020 (APC: 0.85, p = 0.030). Adult men had higher AAMRs than women (men: 40.2; women: 25.2), with increases for both sexes [Men: AAPC: 4.75, p = 0.002; Women: AAPC: 2.70, p = 0.058]. AAMRs varied significantly by race, highest among Black individuals (39.9), followed by Whites (31.4), American Indians (30.4), Hispanics (27.7), and Asians (21.3). The AAMR increased for all races from 1999 to 2020, most notably in American Indians (AAPC: 4.91, p = 0.004). AAMRs varied by state, from 16.4 in Utah to 51.4 in West Virginia. The Midwest had the greatest regional death rate (33.6), followed by the West (31.1), Northeast (31.0), and South (30.9). Nonmetropolitan areas had higher AAMRs than metropolitan areas (34.7 vs. 31.0), with a greater increase in nonmetropolitan areas (AAPC: 6.22, p < 0.000001).Conclusion:This analysis reveals significant demographic and geographic disparities in mortality rates due to CAD in hypertensive adults in the U.S. The AAMR has increased fivefold over the past two decades, particularly among certain racial groups and geographical regions. These findings underscore the urgent need for targeted interventions and equitable healthcare access to mitigate these disparities and improve outcomes.

Circulation, Volume 150, Issue Suppl_1, Page A4142236-A4142236, November 12, 2024. Background:Early aspirin is standard of care after acute ischemic stroke (AIS). There is increased incidence of venous thromboembolism (VTE) in patients with AIS and reduced mobility, but thromboprophylaxis with low molecular weight heparin (LMWH) must be weighed against the risk of bleeding. We compared safety and efficacy of early aspirin with or without LMWH in AIS and reduced mobility.Methods:Patients with AIS and Modified Rankin Scale of 4-5 were identified in the TriNetX Research Database. Patients were categorized as either aspirin alone or aspirin plus LMWH within 72 hours of AIS. We excluded patients receiving any other anticoagulant, thrombolytic agents, or with history of long-term anticoagulation or atrial fibrillation. Bivariable analysis was performed with chi-square and independentt-tests. Cohorts were then 1:1 propensity score-matched by 26 relevant covariables including demographics, comorbidities, and medications. Outcomes were all-cause mortality, VTE, intracranial hemorrhage, and extracranial hemorrhage at 30 and 90 days.Results:We included 2,572 patients in each cohort. Mean age and SD was 71±13, and 48% were male. There was no significant difference in all-cause mortality in patients treated with aspirin alone versus aspirin plus LMWH at 30 days (RR=1.1, 95% CI: 0.91-1.3) or 90 days (RR=1.2, 95% CI: 0.98-1.3). Similarly, the risks of VTE and intracranial or extracranial hemorrhage were not significantly different at either timepoint.Conclusions:In patients with AIS and reduced mobility, the early addition of LMWH to aspirin may have similar risks of bleeding, all-cause mortality, and VTE.

Circulation, Volume 150, Issue Suppl_1, Page A4145554-A4145554, November 12, 2024. Background:Cancer and obstructive sleep apnea (OSA) individually elevate cardiovascular diseases (CVD) and stroke risk. However, it is unclear whether OSA contributes additional CVD risk in persons with pre-existing cancer.Methods:Using the TriNetX, an electronic healthcare records-based database from large healthcare organizations, we compared adverse CVD outcomes and ischemic stroke incidence between patients with and without OSA diagnosed with cancer between 01/2012 and 06/2023. Adverse CVD outcomes was defined as a composite of incident heart failure, incident atrial fibrillation / flutter, incident myocardial infarction or all-cause mortality. Patients were eligible to enter the cohort on the day of cancer diagnosis. The follow-up period for outcome events began one year after patients entered the cohort and patients contributed follow-up time till the outcome event occurred or till the end of the study period.After propensity risk score matching on demographics and comorbidities we conducted a time-to-event analyses.Results:A total of 509,477 patients with both cancer and OSA were propensity score matched to 509,477 patients with cancer but without OSA. The table shows the demographic and comorbidities of the matched groups. Among persons with cancer, OSA diagnosis was associated with increased risk of adverse CVD outcomes (HR: 1.37, 95% CI: 1.36 – 1.38). OSA in persons with cancer increased the risk of heart failure, atrial fibrillation / flutter and myocardial infarction. OSA also increased the risk of ischemic stroke. However, total mortality risk was reduced among those with OSA. See the table for details.Conclusion:OSA increases the risk of adverse CVD outcomes and ischemic stroke in persons with cancer. These analyses suggest that persons with cancer should be screened and treated for OSA. Future studies will need to determine the impact of OSA treatment e.g., positive airway pressure (PAP) therapy on CVD related outcomes in persons with cancer. Further investigation into the paradoxical reduction in all-cause mortality with OSA is warranted.

Circulation, Volume 150, Issue Suppl_1, Page A4139880-A4139880, November 12, 2024. Background:Patients with Coronary Artery Disease are at an increased risk of Atrial Fibrillation related mortality via various mechanisms like Ischemia, Atrial stretch and remodeling, but largely as side effects of treatments. Thus, AF in patients with CAD is a critical health concern among older adults (65+) in the United States. Our CDC analysis focuses on unraveling mortality trends among patients grappling with both conditions from 1999 to 2020.Methods:A retrospective analysis was conducted using national mortality data from the multiple causes of death files in the CDC WONDER database from 1999 to 2020, employing ICD codes I48 for AF and I25.1 for CAD. Age-adjusted mortality rates (AAMRs) per 100,000 people were calculated for the total population, stratified by gender, race, urban/rural metro status, and census region. Annual Percent Change (APC) was calculated using the Joinpoint regression software.Results:A total of 564,952 AF-related deaths among older adults aged 65+ with CAD occurred in the U.S. between 1999 and 2020. Majorly occurred in medical facilities (36.5%). The overall AAMR for AF in CAD-related deaths increased from 49.7 per 100,000 in 1999 to 84.4 in 2020, with an AAPC of 2.52 (95% CI: 2.29 to 2.76, p < 0.000001). A moderate rise in AAMR from 1999 to 2016 (APC: 1.75, p < 0.000001), then significant surge from 2016 to 2020 (APC: 5.88, p < 0.000001). Men had higher AAMRs than Women (83.8 vs 46.6), with a more pronounced increase in men (AAPC: 3.44, p < 0.000001) compared to women (AAPC: 1.23, p < 0.000001). Racially, White population had the highest AAMRs (67.1), followed by American Indians or Alaska Natives (41.9), Hispanics (33.7), Blacks (32.2), and Asians (28.1). All racial groups saw significant increases in AAMRs, most notably among American Indians or Alaska Natives (AAPC: 4.64). Geographically, AAMRs varied, with Rhode Island having the highest (103.5) and Nevada the lowest (29.7). The Midwest had the highest regional AAMR (65.1), while nonmetropolitan areas exhibited higher AAMRs than metropolitan areas, both showing overall increase throughout study (3.34 vs 2.23).Conclusion:This analysis reveals increasing trends and demographic disparities in mortality rates due to AF in CAD patients among older adults in the U.S. The recent surge in mortality rates highlights the need for targeted interventions to address these disparities and improve health outcomes for this vulnerable population.

Circulation, Volume 150, Issue Suppl_1, Page A4147410-A4147410, November 12, 2024. Introduction:Advancements in antiretroviral therapy (ART) have significantly increased the lifespan of patients living with HIV over the past decade. Studies have shown higher mortality and morbidity rates following acute coronary syndrome (ACS) in HIV patients, attributed to traditional cardiac risk factors, psychosomatic illness, metabolic effects of ART, and chronic immune activation caused by HIV.Hypothesis:We hypothesized that HIV patients presenting with ACS in the form of STEMI would have poorer in-hospital clinical outcomes compared to patients without HIV.Aims:We hypothesized that HIV patients presenting with ACS in the form of STEMI would have poorer in-hospital clinical outcomes compared to patients without HIV.Methods:We queried the National Inpatient Sample (NIS) Database from 2015-2019 using ICD-10 codes to identify STEMI patients with and without HIV. Propensity matching adjusted for confounders. The primary outcome was in-hospital mortality; secondary outcomes included major bleeding, the need for mechanical circulatory support (MCS), and net adverse clinical events (NACE). STATA was used for statistical analysis.Results:A total of 581,859 patients were included in the analysis. Baseline comorbidities are listed in Table 1. STEMI patients with HIV were younger (54±12 vs 63±18 years) and had higher rates of liver disease, renal failure, depression, polysubstance abuse, and a history of MI. After propensity matching, in-hospital mortality was similar between both subgroups (Table 2). No significant differences were found between the subgroups in NACE, need for MCS, and major bleeding.Conclusion:Despite being a strong risk factor for CAD, the presence of HIV did not influence in-hospital clinical outcomes in patients presenting with STEMI. This may reflect improved ACS protocols, advancements in ART, and a younger patient cohort. Additional studies are needed to further validate these findings.

Circulation, Volume 150, Issue Suppl_1, Page A4139732-A4139732, November 12, 2024. Background:Pulmonary embolism (PE) occurs in 1% of patients with nontraumatic intracranial hemorrhage (ICH) despite thromboprophylaxis. Anticoagulation is the primary treatment of hemodynamically stable PE; however, risks of bleeding complications in ICH exist. We investigated the optimal timing of anticoagulation in patients with PE and ICH using a large retrospective database.Methods:We included patients with nontraumatic ICH and PE without acute cor pulmonale or prior long-term anticoagulation from the TriNetX Research Network. Patients were then categorized as early (0-3 days after ICH), intermediate (4-14 days), late (15-60 days), or no anticoagulation. Chi-square and independentt-tests were used for bivariable analyses. Cohorts were 1:1 propensity score-matched by 17 covariables including demographic information and comorbidities. Outcomes were all-cause mortality, neurological deficits due to ICH, and extracranial hemorrhage 90 days after ICH.Results:Of 13,042 included patients, mean age was 65±16 and 45% were female. Those receiving early anticoagulation after ICH had higher risk of mortality (RR=1.29, 95% CI: 1.20-1.38), neurological deficits, and extracranial hemorrhage compared to no anticoagulation. Intermediate anticoagulation had similar outcomes to no anticoagulation. Late anticoagulation had lower risk of mortality (RR=0.78, 95% CI: 0.66-0.92) and no significant difference in other outcomes.Conclusions:In patients with ICH and PE without acute cor pulmonale, early anticoagulation was associated with increased mortality, neurological deficits, and extracranial hemorrhage compared to no anticoagulation. Late anticoagulation was associated with decreased mortality and similar risks of neurological deficits and extracranial hemorrhage.

Circulation, Volume 150, Issue Suppl_1, Page A4116285-A4116285, November 12, 2024. Background:Low molecular weight heparin (LMWH) is the preferred anticoagulant for venous thromboembolism (VTE) prophylaxis in patients with ischemic stroke and reduced mobility. However, some patients may have indications for early direct oral anticoagulants (DOACs) and are continued on this therapy rather than transitioning to LMWH. Whether outcomes differ between these groups is unknown. We compared the safety and efficacy of early DOACs versus LMWH from a large retrospective database.Methods:Patients within the TriNetX Research Network receiving either DOACs or LMWH within 72 hours of ischemic stroke and a Modified Rankin Scale of 4-5 were included. A 1:1 propensity score matching analysis was performed using 27 covariables including demographic information, comorbidities, and medications. Chi-square and independentt-tests were used in bivariable analyses. Outcomes were all-cause mortality, VTE, intracranial and extracranial hemorrhage at 30 and 90 days.Results:Of 5,492 propensity-matched patients, mean age was 73±13, and 43% were male. Mortality in the DOAC group was significantly lower than in the LMWH group at 30 days (RR=0.59, 95% CI: 0.51-0.69) and 90 days (RR=0.63, 95% CI: 0.56-0.71). Risk of VTE was not significantly different at 30 days (RR=0.80, 95% CI: 0.43-1.50) or 90 days (RR=0.74, 95% CI: 0.45-1.22). Risk of intracranial hemorrhage was not significantly different at 30 days (RR=0.81, 95% CI: 0.36-1.80) or 90 days (RR=0.62, 95% CI: 0.34-1.15).Conclusions:In patients with acute ischemic stroke and reduced mobility, early use of DOACs was associated with lower mortality compared to early use of LMWH.

Circulation, Volume 150, Issue Suppl_1, Page A4146633-A4146633, November 12, 2024. Background:Catheter-Directed Interventions (CDIs) for Acute Pulmonary Embolism (PE) have been present for years but their use is limited due to paucity of data especially in patients with cancer. We examine the safety and efficacy of CDIs in patients with high-risk PE and cancer.Methods:Nationwide Readmissions Database (2016-2021) was used to analyze cancer patients presenting with high-risk PE (HR-PE) (shock, pressor or mechanical circulatory support requirement). Patients who received systematic thrombolysis were excluded. Mahalanobis Distance Matching within the Propensity Score Caliper was used to match patient who received CDIs vs those who were treated with anticoagulation alone. Inverse Probability weighting (IPW) was utilized, and Pearson’s chi-squared test was applied to the PSM-2 matched cohorts to compare outcomes.Results:Among 265,196 hospitalization of cancer patients with HR-PE, X were treated with systemic thrombolysis and 795 (0.3%) of the patients underwent CDI.After propensity matching (N: 421 in each group), patients receiving CDI had a significantly lower mortality (33% vs. 41.8%, aOR:0.76 (95% CI, p: 0.008); However, bleeding complications including major bleeding (10.7% vs 6.2%, aOR:1.97 (95% CI, p: 0.018) was higher in patients receiving CDIs. No difference was observed in the risk of intracerebral hemorrhage (p >0.05). Readmission rates were similar at 30-day and 90-day intervals (p >0.05). From 2016-2021, mortality associated with HR-PE in cancer has not changed significantly (p >0.05); however, mortality in patients undergoing CDIs has decreased from (43.8% to 22.6%, p-trend: 0.0004). There has been increasing use of mechanical thrombectomy (MT) over thrombolysis in recent years.Conclusion:CDIs for HR-PE in cancer patients are associated with significant reduction in mortality and associated with higher bleeding. Mortality has decreased across the years for patients undergoing CDIs with higher utilization of MT.

Circulation, Volume 150, Issue Suppl_1, Page A4138475-A4138475, November 12, 2024. Background:The annual number of transcatheter aortic valve implantation (TAVI) performed has surpassed that of surgical aortic valve replacement (SAVR) as its use expands to patient populations not included in initial clinical trials. However, in patients with Right Heart Failure (RHF), the outcomes of TAVI and SAVR remain unclear.Methods:We conducted a retrospective cohort study using the Nationwide Readmission Database from 2018 to 2021. Using ICD-10 codes, we identified all adult admissions for TAVI and SAVR with the presence of RHF. The primary outcome was in-hospital mortality. Secondary outcomes included in-hospital complications, 30-day readmission rate, length of stay, and total hospitalization charges.Results:The study included 3,712 adult patients with RHF, of which 1,386 (37.3%) underwent TAVI and 2,326 (62.7%) underwent SAVR. Compared to SAVR patients, TAVI patients were older (63 years vs. 76 years, p

Circulation, Volume 150, Issue Suppl_1, Page A4142312-A4142312, November 12, 2024. Introduction:Patients with cancer have a higher risk for both arterial and venous thromboembolism. Furthermore, this population subset has an increased risk of bleeding when treated with anticoagulation. Left atrial appendage occlusion devices (LAAODs) have emerged as an alternative to oral anticoagulation in patients at high risk for bleeding events. There is a paucity of data regarding the efficacy of LAAODs in cancer patients. In our study, we investigated the readmission rates, predictors, and causes of readmission after LAAODs placement in patients with underlying malignancy.Methods:The National Readmission Database for 2016, 2018, and 2020 was queried to identify hospitalized adults for LAAOD placement with a history of cancer. Multivariate logistic and linear regression analyses were used to adjust for possible confounders.Results:A total of 566 patients were hospitalized for LAAOD placement and had a history of different malignancies with 563 discharged alive. Within 90 days from discharge, 141 patients (25%) were readmitted. Exacerbation of Congestive heart failure (CHF) (7.9%), Sepsis (6.7%), Lower GI bleeding (4.3%), Iron deficiency anemia (3.8%), unspecified gastrointestinal hemorrhage (3.1%), and paroxysmal Atrial fibrillation (2.6 %) were most common causes of readmissions. Independent predictors of readmission included female sex (aOR 1.68, 95% CI: 1.07 – 2.63, P=0.022), acute kidney injury (aOR 4.6, 95% CI: 1.5-8.4, P=0.008), and anemia (aOR 1.71, 95% CI: 1.08-2.7, P=0.023).Conclusion:Predictors of readmission included female sex, anemia, and acute kidney injury during index admission. The most common causes of readmission included Exacerbation of CHF, Sepsis, Lower GI bleeding, and Iron deficiency anemia. Addressing readmission causes and predictors is needed to prevent such a high rate of readmissions after LAAODs placement in cancer patients.

Circulation, Volume 150, Issue Suppl_1, Page A4146996-A4146996, November 12, 2024. Background:Due to increased life expectancy, there is increasingly high prevalence of myocardial infarction (MI) in older adults (age ≥75 years). Older adults tend to receive less guideline recommended treatment for MI due to associated frailty. We compare the management and outcomes in older adults with ST elevation myocardial infarction (STEMI) and cardiogenic shock (CS) as compared to adults age

Circulation, Volume 150, Issue Suppl_1, Page A4147962-A4147962, November 12, 2024. Introduction:Heart transplants (HT) and left ventricular assist devices (LVADs) are treatment options for advanced heart failure refractory to standard therapy. Historically, LVADs have been used as either destination therapy or a bridge to transplant. However, recent changes to the organ allocation system have deprioritized patients on LVADs as transplant recipients, leading to divisive views on the role of an LVAD. We sought to describe outcomes with each modality, highlighting each option’s strengths and clinical utility.Aim:To assess costs related to index hospitalization, 30-day (30DRC) and 90-day (90DRC) readmission categories for both subgroups.Method:We analyzed the National Readmission Database (NRD) from January 1, 2018, to December 31, 2021, identifying patients with HT and LVAD via ICD-10-CM codes. We selected this recent time frame to limit the influence of older LVAD technology and heart allocation schemes. We excluded patients

Circulation, Volume 150, Issue Suppl_1, Page A4147416-A4147416, November 12, 2024. Background:Atrial Fibrillation (AF) and congestive heart failure (CHF) are intertwined disorders that contribute to cardiovascular morbidity and mortality. Arrhythmia burden is a key prognostic factor in patients with AF and CHF. Numerous studies have suggested that catheter ablation outperforms conventional therapies in improving clinical outcomes for these patients. This study aims to evaluate the racial disparities affecting periprocedural outcomes and mortality in CHF patients undergoing AF ablation.Methods:We searched the National Inpatient Sample (NIS) data from 2016 to 2021 using ICD-10 and ICD-10-PCS9 codes to look for patients with CHF who underwent ablation for AF and stratified the data on the basis of race, particularly African American(AA) and White American (WA) population. We used the Pearson Chi-Square test to analyze categorical variables and the Wilcoxon Rank Sum test for continuous variables to evaluate racial disparities in the periprocedural outcomes in patients undergoing ablation. Additionally, we also used a multivariate logistic regression analysis to compute adjusted odds ratios (aORs) for outcomes.Results:After analyzing NIS data from 2016 to 2021, among 7,803,487 patients admitted for AF and CHF, only 94,245 underwent ablation. Among those who underwent ablation, AA were admitted and received ablation at a younger age compared to WA (63.89 years versus 71.48 years). We found that AA patients experienced higher rates of HF exacerbation (91% vs 88.9%, p:0.006, ), cardiogenic shock (7.8% vs 5.6%, p