Abstract 4134655: Clinical Outcomes of Patients with Alcoholic Cirrhosis and Acute STEMI Undergoing PCI

Original research: Background: The objective is to evaluate the outcomes of percutaneous coronary intervention (PCI) in patients with alcoholic cirrhosis presenting with ST-segment elevation myocardial infarction (STEMI). Methods: We analyzed data from the National Inpatient Sample (NIS) for the years 2016-2020. Our cohort included patients admitted with STEMI and a secondary diagnosis of alcoholic cirrhosis, excluding those under 18 or those not receiving PCI. Propensity score matching using a kernel method was applied to adjust for 22 variables, including patient demographics, hospital characteristics, and comorbid conditions. Results: Among 119,799 patients, 98 had alcoholic cirrhosis. These patients exhibited higher mortality (18% vs. 5%) and longer hospital stays (5.4 days vs. 3.6 days). They also had increased risks of acute blood loss anemia (13% vs. 3.5%) and gastrointestinal bleeding (18% vs. 2%). Additionally, acute kidney injury was more prevalent in the cirrhosis group (25.5% vs. 14%). Although heart failure exacerbation and cardiac arrhythmias were more common, these were not statistically significant (Table 1). Conclusion: Our study indicates a significantly higher mortality rate among patients with alcoholic cirrhosis undergoing PCI for STEMI. These patients are also at increased risk of postoperative bleeding due to compromised liver function and hemostatic abnormalities, as reflected by higher incidences of acute blood loss anemia and gastrointestinal bleeding. Additionally, there is an elevated risk of acute kidney injury post-PCI, highlighting the need for renal-protective strategies. These findings stress the necessity for specialized care, vigilant monitoring, and tailored protocols to address the unique challenges faced by this population, aiming to reduce morbidity and mortality.