Abstract 4142648: Cardiac Catheterization in Kidney Transplant Patients Presenting with Non-ST Segment Elevation Myocardial Infarction: A Five-year Nationwide Analysis

Background: Cardiovascular disease is a significant cause of death among kidney transplant (KT) patients. The potential for contrast-induced nephropathy renders cardiac catheterization challenging for patients with non-ST segment elevation myocardial infarction (NSTEMI). Aims: To identify and evaluate the rates of all-cause mortality, intensive care unit (ICU) admission, cardiac catheterization, and length of stay between KT patients and non-KT patients who were admitted for NSTEMI. Methods: Our retrospective analysis utlized data from the Nationwide Inpatient Sample Database (NIS) from January 2016 to December 2020. A total of number of 31,51,154 non-KT were compared with 11,935 KT patients were admitted for NTSEMI. We identified patients who were admitted to the hospital in the US with discharge diagnosis of NSTEMI comapring their outcomes based on their renal transplant status. A multivariate logistic and linear regression analysis were conducted and adjusted for confounding variables such as age, gender, race, insurance, income, hospital region, and medical comorbidities to evaluate outcomes of interest. The adjusted odds ratio (aOR) and 95% confidence intervals (CI) were calculated. Results: Our analysis showed that patients with KT were less likely to undergo cardiac catheterization (aOR = 0.66, 95% CI: 0.60-0.73) compared to non-KT patients. There was no significant difference in the risk of cardiac arrest (aOR = 0.72, 95% CI: 0.43-1.22), ICU admissions (aOR = 1.09, 95% CI: 0.95-1.25), and the length of stay was found to be comparable in between the two groups. However, there was an increased risk of all-cause mortality (aOR = 1.28, 95% CI: 1.083-1.527) in KT patients when compared to non-KT patients. Conclusion: For NSTEMI, KT patients underwent cardiac catheterization significantly less frequently than their non-KT patients. patients Additionally, patients with KT had a higher risk of mortality than non-KT patients. Nonetheless, the risk of cardiac arrest, ICU admission, and duration of stay were comparable among the two groups, indicating that the potential side effects associated with left heart catheterization should not outweigh the benefits of performing left heart catheterization in KT patients.