Abstract 4145447: Impact of Acquired Thrombophillia on Inpatient Outcomes Among Hospitalized Patients With Acute Coronary Syndrome

Introduction: Acute Coronary Syndrome(ACS) is a disease entity that can have high mortality if other risk modifiying factors are inadequately controlled. In this study, we examined the effect of acquired thrombophillas like antiphospholipid syndrome, Heparin induced thrombocytopenia (HIIT) and Jak 2 Mutation on outcomes in inpatients hospitalized with ACS;all of which can be commonly associated with myocardial infarction and other arterial thombotic sequelae, Methods: Retrospective cohort analyses were conducted using data from the National Inpatient Sample (NIS) collected between 2016 and 2020. Multivariate logistic and linear regression modelling was used to access the impact of acquired prothrombotic factors on inpatient outcomes among hospitalized patients with acute coronary syndrome.Our primary outcome of interest was in-hospital mortality. Secondary outcomes were length of stay and cost of hospitalization or total hospital charges. Results: Of the 2,389,836 hospitalizations with acute coronary syndrome, 32% had a diagnosis of an acquired prothrombotic factor. Among those with these acquired prothrombotic factors, 40% had a diagnosis of HIT, 25% had a diagnosis of APS and 35% had a diagnosis of JAK 2 mutation. In the adjusted analyses, patients who had acute coronary syndrome with a concurrent diagnosis of an acquired prothrombotic factor (AOR: 2.28; 95% CI: 1.84-3.99) had higher odds of mortality compared to those without an acquired prothrombotic factor. Length of stay (ß: 1.23; 95% CI: 1.01-1.76) was found to be longer among those with acquired prothrombotic factor relative to those without. Furthermore, having an acquired prothrombotic factor was associated with higher hospital charges (ß: 1281.22; 95% CI: 28.65-4364.98) compared to those without an acquired prothrombotic factor. Conclusion: Acquired thrombophilias are associated with increased in-hospital mortality , length of stay and cost of hospitalization. Further studies are needed to elucidate the predictors of higher mortality in these patients, which could be translated into clinical practice to further identify high risk patients