Abstract P184: Systolic Dysfunction is Associated With Increased Occurrence and Worse Outcomes of Periprocedural Cardiovascular Adverse Events After Percutaneous Transluminal Coronary Angioplasty

Background: The percutaneous transluminal coronary angioplasty (PTCA) rate continues to increase nationwide, and better strategies to achieve negligible complication rates are required. Data on risk assessment specific to cardiovascular complications are limited. Hypothesis: The presence of systolic dysfunction is associated with increased frequency and adverse outcomes of periprocedural cardiovascular complications among patients undergoing percutaneous transluminal coronary angioplasty. Method: A retrospective cohort study was designed using data obtained from the 2016 to 2018 combined National Inpatient Sample (NIS) database. The current procedural terminology (CPT) Codes of ICD-10 were used to identify patients admitted for percutaneous transluminal coronary angioplasty. They were then dichotomized into two cohorts based on the presence of systolic dysfunction. Primary outcomes were death, length of stay, total charge, composite of all cardiovascular perioperative adverse events and composite of all cardiovascular perioperative adverse events and death. Secondary outcomes were individual cardiovascular perioperative adverse events for all PTCA admissions and subsequently for patients with post-PTCA cardiac dysfunction. Multivariate linear and logistic regressions were used to adjust for confounders. Results: There was a total of 1,176,340 admissions for percutaneous transluminal angioplasty among whom were 145,330 with systolic dysfunction. Details of study outcomes are summarized in table 1 below. Conclusion: Among inpatients who underwent PTCA, systolic dysfunction is associated with higher odds of; composite of all periprocedural cardiovascular adverse outcomes, and composite of death and periprocedural adverse outcomes. This is largely driven by increased odds of all-cause mortality and odds of periprocedural cardiac dysfunction, particularly with increased ventricular tachycardias and cardiogenic shock. There was increased length of stay and total charge.