Abstract 4147410: Impact of HIV on In-Hospital Outcomes in STEMI Patients: A Propensity-Matched Analysis from the NIS Database

Introduction: Advancements in antiretroviral therapy (ART) have significantly increased the lifespan of patients living with HIV over the past decade. Studies have shown higher mortality and morbidity rates following acute coronary syndrome (ACS) in HIV patients, attributed to traditional cardiac risk factors, psychosomatic illness, metabolic effects of ART, and chronic immune activation caused by HIV. Hypothesis: We hypothesized that HIV patients presenting with ACS in the form of STEMI would have poorer in-hospital clinical outcomes compared to patients without HIV. Aims: We hypothesized that HIV patients presenting with ACS in the form of STEMI would have poorer in-hospital clinical outcomes compared to patients without HIV. Methods: We queried the National Inpatient Sample (NIS) Database from 2015-2019 using ICD-10 codes to identify STEMI patients with and without HIV. Propensity matching adjusted for confounders. The primary outcome was in-hospital mortality; secondary outcomes included major bleeding, the need for mechanical circulatory support (MCS), and net adverse clinical events (NACE). STATA was used for statistical analysis. Results: A total of 581,859 patients were included in the analysis. Baseline comorbidities are listed in Table 1. STEMI patients with HIV were younger (54±12 vs 63±18 years) and had higher rates of liver disease, renal failure, depression, polysubstance abuse, and a history of MI. After propensity matching, in-hospital mortality was similar between both subgroups (Table 2). No significant differences were found between the subgroups in NACE, need for MCS, and major bleeding. Conclusion: Despite being a strong risk factor for CAD, the presence of HIV did not influence in-hospital clinical outcomes in patients presenting with STEMI. This may reflect improved ACS protocols, advancements in ART, and a younger patient cohort. Additional studies are needed to further validate these findings.