Abstract 4147579: Nationwide trends in Major Adverse Cardiac and Cardiovascular Events and ALL-cause Mortality in Cardiovascular-Kidney-Metabolic Syndrome Among Geriatric Patients.

Background: The American Heart Association (AHA) has acknowledged the interconnection of obesity, type 2 diabetes mellitus (DM), cardiovascular disease (CVD), and chronic kidney disease (CKD) as a complex health disorder named Cardiovascular-Kidney-Metabolic (CKM) syndrome. Patients with CKM progress to major adverse cardiac and cerebrovascular Events (MACCE). The aim of the study is to analyse nationwide trends in MACE and all causes. mortality among patients aged 65 years and older with CKM syndrome. Methods: Using a National Inpatient Sample (2016–2020) geriatric admissions among patients admitted with CKD and at least One cardiometabolic risk factor (HTN, DM, HLD, and obesity) were selected using ICD-10. codes. Patients were classified into MACCE+ve cohorts if they had acute myocardial infarction, cardiac arrest or acute ischaemic stroke present otherwise into MACCE-ve. Trends, Demographics, comorbidities, and all-cause mortality were analysed between the two cohorts. Results: In our NIS study, the MACCE+ve and -ve cohorts had median ages of 78 (72–85) and 78 (72–85). years with 55.9% and 51.1% males and 44.1%. and 48.9% females, respectively. over a period of 5 years (2016–2020) in patients with CKM syndrome hospitalisation has increased with MACCE (from 10.4% to 12.7%) with an increase in hospital mortality (4.6% to 6%) (ptrend<0.001). In our analysis, patients with CKM admitted to MACCE had statistically significant all-cause mortality (15.3% vs. 3.4%), total length of stay (5 vs. 4), and hospital cost ($66,824 vs. $43,727) compared to MACCE-ve cohorts (p-value < 0.001). Conclusion: Our analysis suggests alarmingly rising trends in MACCE in CKM syndrome, which significantly impacts in-hospital outcomes. We need to conduct more studies to enhance our comprehension of managing CKM syndrome.