F-17 | Pulmonary Hypertension Drastically Worsens Short and Long-term Outcomes in Pericarditis Patients with Pericardial Effusion; A US Cohort Propensity-Matched Study

Background: Coronary computed tomography angiography (CCTA) is a key non-invasive tool for evaluating coronary artery disease, but it can lead to downstream invasive coronary angiography (ICA).The burden and appropriateness of ICA after CCTA remain unclear, with significant variability in practice patterns.Understanding this burden is vital for optimizing care and resource use.Methods: We conducted a retrospective analysis of the 2016-2020 Nationwide Inpatient Sample to identify adult patients (>18 years) who underwent CCTA and ICA using ICD-10-CM codes.Patients who had CCTA performed after ICA were excluded.National estimates were calculated using appropriate weights, and all reported results represent weighted estimates.Results: During the study period, 27,640 patients underwent CCTA, of whom 11,200 (40.5%) had primary CCTA before ICA and were included.44.8% of these patients eventually underwent ICA, of which, 71.4% received a drug-eluting stent (DES), and 4.2% underwent coronary artery bypass grafting (CABG).Separately, there were 4,894,520 patients who underwent primary ICA and were generally older (65.3 years, SE 0.013) compared to those undergoing primary CCTA (63.9 years, SE 0.26).Primary ICA patients had more comorbidities when compared with primary CCTA patientshypertension (83.0% vs. 80.4%),COPD (18.9% vs. 13.3%), and diabetes (40.9% vs. 35.0%).Primary CCTA patients had higher rates of personal (92.3% vs. 80.9%) and family history of CAD (24.9% vs. 15.0%).Female sex was more common among primary ICA patients (37.6% vs. 33.6%).Primary ICA patients had higher incidence of cardiogenic shock (4.9% vs. 2.8%) and in-hospital mortality (2.6% vs. 1.2%).After excluding patients with STEMI and cardiogenic shock, mortality rates were 1.2% for ICA and 0.5% for CCTA.Conclusions: The rate of ICA is high in patients undergoing CCTA.Despite initial CCTA evaluation, it does not seem to significantly alter hospital outcomes, suggesting that CCTA may be associated with increased downstream ICA and DES usage.Patients undergoing primary ICA have more underlying comorbidities and higher mortality rates.