Abstract 4142056: Impact of Obstructive Sleep Apnea on In-Hospital Outcomes of Adults with Hypertrophic Cardiomyopathy

Background: Obstructive sleep apnea (OSA) has been reported in a sizable proportion of adults with hypertrophic cardiomyopathy (HCM) and has been associated with higher incidence of adverse outcomes including arrhythmias (atrial fibrillation, non-sustained ventricular tachycardia) and sudden cardiac death when untreated. We aimed to evaluate the impact of OSA on in-hospital outcomes of patients with HCM. Methods: National Inpatient Sample 2016-2020 was queried to identify admissions for HCM patients with (HCM+OSA) and without (HCM-OSA) OSA. In-hospital outcomes were compared with use of logistic regression. Results: From 2016-2020, 271,085 adults with HCM were admitted to hospital of whom 45,135 (16.6%) were identified to also have OSA. Age was similar between both groups. (Table) Comorbidities (diabetes, coronary artery disease, hyperlipidemia, and chronic kidney disease) were more prevalent among HCM+OSA [Table]. Additionally, HCM+OSA more often had the obstructive phenotype (43.8 vs. 42.87%, p<0.001), heart Failure with preserved ejection fraction (37.75 vs. 27.01%, p<0.001), and paroxysmal atrial fibrillation (24.65 vs. 19.76%, p<0.001) and more frequently underwent septal reduction therapy [surgical myectomy (2.61 vs. 2.09%) or alcohol septal ablation (0.94 vs. 0.76%), both p<0.001)]. In-hospital outcomes such as overall mortality, need for intensive care unit admission, mechanical ventilation, mechanical circulatory support and use of vasopressors did not differ among patients with HCM and with or without SH [Table]. Conclusion: In this study, 1 in ~6 adults with HCM admitted to hospital also had OSA. OSA in HCM was associated with higher prevalence of comorbid conditions and the obstructive phenotype and thus higher rates of septal reduction therapy. However, presence of OSA did not impact in-hospital outcomes of HCM in this study.