(206) In-Hospital Outcomes Associated With Inflammatory Bowel Disease in STEMI Patients

Introduction: Chronic inflammatory disease states including psoriasis, lupus and rheumatoid arthritis are associated with a higher incidence of STEMIs. However, data on STEMIs are scarce in inflammatory bowel disease (IBD) and outcomes of STEMI patients such as mortality in IBD are scarce. Inflammation, the hallmark of IBD, also overlaps with the pathophysiology of coronary atherosclerosis. Thus, we sought to evaluate potential outcome (mortality) of IBD in STEMI patients in a nationally representative adult US population.

Methods: This was a retrospective analysis of the 2015-2020 National Inpatient Sample (NIS) database, the largest inpatient care database in the United States. The US-based NIS was queried during this time period using ICD-10 codes for adults ≥ 18 years with STEMI with and without IBD. The adjusted odds ratio of index hospitalization outcomes was calculated using a multivariate logistic regression analysis.

Results: Overall only 0.44 percent reported IBD in STEMI patients. Those with IBD were middle aged and predominantly female compared to non-IBD in STEMI patients. IBD patients also had similar CVD risk factors (hypertension, obesity) than non-IBD participants (p>0.05), however prevalence of smoking and Diabetes were lower in IBD patients (P < 0.001) whereas cost of hospitalization and length of hospital stay was higher in IBD patients (p < 0.05). Moreover, IBD patients had lower mortality compared to non-IBD patients with STEMI (P < 0.001), however on adjustment for baseline CVD risk factors and hospital characteristics, this difference completely attenuated (P=0.50). (Table 1)

Conclusions: In a nationally representative adult US population we observed no difference in mortality, but higher cost of hospitalization and length of hospital stay in IBD with STEMI patients. Chronic inflammatory states play a role in endothelial dysfunction and thus acute coronary syndrome risk. The findings in this study need to be confirmed in prospective cohorts and the biological mechanisms evaluated in translational studies. Future studies should also examine how IBD therapy may potentially limit these risks.