Abstract 4146535: Prevalence and In-hospital Outcomes of Cardiac events in Women with underlying Infertility Condition:A National Inpatient Database Analysis

Introduction: Cardiovascular(CV) disease is one of the leading cause of death in females in USA out of which 44% suffer. According to the latest CDC guidelines, 13.4 % are suffering from the infertility.It includes the most common conditions including endometriosis, poly cystic ovarian syndrome. Studies shows a mutlitude of factors including genetic abnormalities, hormonal imbalances like chronic anovulation or increased androgens predispose the women to subsequent health conditions.Literature review suggests that long term cv risks are less understood in the infertile women. Aim: The aim of the study is to identify the CV outcomes including coronary heart disease(CAD) , acute coronary syndrome(ACS), and heart failure in women with underlying infertility condition. Methods: The NIS 2020 was queried for the female adult population (age>18 years) with a primary or secondary diagnosis of infertility. Prevalence of CV risk factors were compared between females with and without infertility problem. The association of cardiac diagnoses including CAD, ACS and was analysed. Multivariate regression analysis was performed taking all-cause mortality as a primary outcome. Results: A total of 3870 adult patients with a primary or secondary diagnosis of infertility were identified and the mean age was 36 years.In adult population without infertility condition, patients with an underlying infertility were found to have an increased association with DM (48.16%vs 23.11%; P<0.001),HLD(56.14% vs 30.72%; P<0.001),hypothyroid(17.47% vs 10.47%; P<0.001),metabolic syndrome(0.23% vs 0.16%; P<0.001) while we found decreased association in tobacco abuse( 14.18% vs 17.12%; P<0.001),HTN(1.47% vs 37.95%; P<0.001). The prevalence of CAD(46.64% vs 12.59%; P<0.001), ACS(46.64% vs 12.59%; P<0.001) was also found to be significantly higher in women with infertility. In the female subpopulation with infertility, approximately 5.91% of patients died. However, the odds of mortality was significantly increased if patients had underlying ACS (OR- 2.77; C.I.-2.72 -2.87; P<0.001) or CAD (OR- 3.97; C.I.: -3.93-4.02; p<0.001). There was no statistically significant increased mortality with HF( OR:1). Conclusion: In our study, infertility in women was associated with higher prevalence of CAD and ACS. The odds of mortality also increased if women with infertility condition if they developed ACS or CAD. Further clinical research and studies are warranted to understand its CV outcomes.