Abstract 4129453: Comparing Cardiovascular Outcomes in Patients with Lyme Disease and Babesiosis: A Retrospective Cohort Study

Intro: In the U.S, Lyme disease and Babesiosis are among the four most common tick-borne illnesses, with an annual average of 36,000 and 2200 cases respectively from 2016-2019. Both have cardiac involvement; 1% of lyme disease cases result in lyme carditis, while babesiosis is associated with arrhythmias and heart failure. Little research has explored the comparative risk of developing cardiac complications between the two. This study investigates cardiovascular complications in cases of Lyme and Babesiosis. Methods: We conducted a retrospective cohort study utilizing data from the TriNetX database and the US Collaborative Network, which together cover 60 healthcare organizations providing real-world electronic health records. We included all individuals diagnosed with either Lyme disease (Cohort A, pre-match n = 317368/post-match n = 4115 ) or babesiosis (Cohort B, pre-match n=4173/post-match n = 4115), identified using ICD-10-CM codes. Patients under 18 years of age, diagnosed with both diseases, or with incomplete follow-up data were excluded. We employed propensity score matching to adjust for age, race, sex, and other clinical parameters to compare the two cohorts equitably. We focused on 4 key outcomes over a 5-year period: arrhythmias, the need for PPM implantation, ACS and HF, utilizing both risk analysis and Kaplan-Meier survival analysis. Results: Interestingly, patients with babesia exhibited a greater likelihood of developing HF (OR: 1.279, 95% CI (1.073,1.524)). The development of arrhythmias between the two groups was not statistically significant with an OR of 1.013 (95% CI (0.837, 1.227)). The need for PPM implantation was not statistically significant between the two groups with an OR of 1.269 (95% CI (0.785, 2.052)). The risk of developing ACS was not statistically significant with an OR of 1.103 (95% CI (0.838, 1.451)) . Conclusion/Discussion: Our findings indicate that patients with babesiosis have a higher likelihood of developing HF compared to those with lyme disease. Surprisingly, there were no significant differences in the rates of arrhythmias or pacemaker implantations between the two cohorts. These results suggest that while overall cardiovascular risks are comparable between the groups, the increased risk of HF in babesiosis needs to be further explored.