Abstract 4147256: The Effect of Obesity on Outcomes of Mechanical Circulatory Support for Acute Myocardial Infarction Complicated by Cardiogenic Shock: Insight from the National Inpatient Sample Database

Introduction: Studies suggest a complex relationship between body mass index (BMI) and percutaneous coronary intervention (PCI) outcomes. However, the effect of obesity on in-hospital outcomes of PCI with mechanical circulatory support (MCS) for acute myocardial infarction complicated by cardiogenic shock (AMICS) has not been established. Objective: To characterize outcomes of PCI with MCS for AMICS in patients with and without obesity. Methods: In the National Inpatient Sample (NIS) 2016-2020, we identified patients with AMICS treated with MCS with obesity (BMI 30.0-39.9) or normal BMI (20.0-24.9). The primary outcome was in-hospital mortality. Secondary outcomes included cardiac arrest, stroke, acute kidney injury, bleeding, acute respiratory failure, palliative consults, hospital length of stay (LOS), and total charges. Multivariate logistic regression models adjusted for baseline characteristics and estimated odds ratios (ORs) with 95% confidence intervals (CIs). Results: 5270 patients met study criteria (4870 obese). Obese and normal weight patients had a mean age of 69.8 vs. 63.5 years and male sex 78.1% vs. 71.3%. Obese patients had more hypertension, diabetes, dyslipidemia, and previous myocardial infarction (Table 1A). There was no difference in mortality [OR 0.84, CI (0.41-1.71), P=0.623] or the secondary outcomes (Table 1B). Normal weight was associated with longer LOS (13.0 vs. 8.5 days) and higher charges ($325,926.3 vs. $294,629.1). Conclusion: There were no significant differences in in-hospital mortality or secondary outcomes between obese and normal-weight AMICS patients treated with PCI and MCS. PCI with MCS may be performed safely in AMICS patients with and without obesity.