D-13 | Bridging the Gap: Regional Disparities in STEMI Outcomes from the Latest Nationwide Database

Background: Spontaneous Coronary Artery Dissection (SCAD) is an infrequent but significant cause of acute coronary syndrome.Anemia (AN) is associated with increased mortality in patients admitted with ACS.However, data on the effect of the severity of anemia on SCAD are limited.This study evaluates the impact of anemia on clinical outcomes in SCAD using a nationally representative inpatient database.Methods: This retrospective cohort study used the National Inpatient Sample (NIS) to analyze adult hospitalizations for SCAD, stratified by the presence or absence of anemia, from 2016 to 2020.Multivariate regression models were adjusted for age, gender, race, income, insurance, comorbidity score, hospital location, and bed size.The primary outcome was all-cause mortality, with secondary outcomes including length of stay and hospital charges.Results: Out of 43,335 hospitalizations for SCAD patients, 25.16% had anemia (SCADA) and 74.84% had no anemia (SCADO).The mean age of SCADA patients was 63.49 AE 14.71 years compared to 60.00 AE 14.16 years (p < 0.001).Both groups were predominantly female (56.78% in SCADO vs. 57.14% in SCADA; p 0.7753).Comorbidities, including coronary artery disease, stroke, chronic obstructive pulmonary disease, electrolyte disorders, liver disease, and hypertension, were more prevalent in SCADA.SCADA was associated with higher All-cause mortality (10.2% vs 4.6%, 95% confidence interval [CI]: 1.97-2.82;p < 0.001), length of stay (9.6 vs. 3.8 days; OR: 3.42; 95% CI: 2.77-4.07;p < 0.001).Hospital charges were greater in SCADA ($320,267.30vs. $155,718.80;difference: $93,452.48;95% CI: $77,989.20;p < 0.001).Odds of cardiogenic shock (23.1% vs 6.8%; 95% CI: 3.59-4.71;p < 0.001), acute kidney injury (33.2% vs 9.3%; 95% CI: 4.28-5.50;p < 0.001), cardiac arrest (6.47% vs 3.59%; 95% CI: 1.50-2.30;p < 0.001), and transfusion (17.44% vs 1.48%; 95% CI: 7.15-12.90;p < 0.001) were significantly higher in SCADA.Conclusions: Anemia is associated with higher predictors of adverse outcomes in SCAD, including increased mortality, length of stay, and resource utilization.Focused initiatives are needed to improve care in SCAD patients admitted with anemia.