Abstract 4138210: In-hospital Mortality and Cardiovascular Complications in Acute Pericarditis among patients with Heart Failure with Preserved Ejection Fraction

Background: Heart failure with preserved ejection fraction (HFpEF), often referred to as diastolic heart failure, presents significant treatment challenges. Acute pericarditis (AP) is a life-threatening illness, yet the literature on its epidemiology and outcomes in HFpEF patients is scarce. Hypothesis: Acute pericarditis in HFpEF patients is associated with increased risks of myocardial infarction, various types of heart block, cardiac tamponade, ventricular arrhythmia, cardiogenic shock, and in-hospital mortality. Aim: This study aims to outline the association of major cardiovascular outcomes with acute pericarditis in hospitalized HFpEF patients. Methods: A retrospective observational cohort study was conducted using the National Inpatient Sample from 2016 to 2020. We included patients with documented AP among those with HFpEF, identified using validated ICD-10 codes. Univariate and multivariate logistic regression analyses identified outcomes and adjusted for potential confounders using the Elixhauser comorbidity index. Results: Among 471,145 hospitalized HFpEF patients, approximately 424 (0.09%) had AP between 2016 and 2020. The mean age was 67, predominantly female (58%), with a mean length of stay (LOS) of 8 days. Among patients with HFpEF, increased cardiovascular complications were associated with AP, including heart block in 5% of patients (OR = 1.3, 95% CI 1.1 to 1.6, p = 0.002), cardiac arrest in 2.3% (OR = 1.6, 95% CI 1.2 to 2.1, p < 0.001), and myocardial infarction in 4.5% of patients (OR = 1.3, 95% CI 1.1 to 1.6, p = 0.015). Ventricular arrhythmias occurred in 2.4% (OR = 1.5, 95% CI 1.2 to 1.9, p < 0.001), cardiogenic shock in 0.39% (OR = 5.4, 95% CI 4.3 to 6.8, p < 0.001), cardiac tamponade in 16.5% (OR = 144, 95% CI 127.2 to 164, p < 0.001), and mortality was 4.25%. However, the association between AP and mortality was not statistically significant (OR = 2.4, p = 0.152) (see Figure 1). Conclusion: Acute pericarditis, while rare in HFpEF patients, is associated with increased major cardiovascular complications, including ventricular arrhythmias, tamponade, cardiogenic shock, and cardiac arrest, particularly with a significant odds ratio for cardiac tamponade.