A-79 | Unmasking the Cardiac Conundrum: NSTEMI Outcomes in Fibromyalgia patients - A Nationwide Perspective

Background: Fibromyalgia (FM) is characterized by widespread musculoskeletal pain, fatigue, sleep disturbances, & cognitive dysfunction.It affects approximately 2-4% of the global population, more common in women.Studies have shown an association between fibromyalgia & an increased risk of coronary heart disease (CHD).Methods: We used the NIS Database from 2018-21 & conducted a retrospective analysis of patients admitted with NSTEMI using ICD 10 code (I214).Our primary population included patients >/18 years with a primary diagnosis of NSTEMI.Patients were divided into two groups, FM & non-FM.We used multivariate analysis to compare odds of various in-hospital outcomes & adjusted for confounders.Results: We identified 1698970 admissions for NSTEMI, of which 21155 (1.25%) also had FM.Mean age of FM group was 60 & non-FM was 50.Primary outcome was in-hospital mortality.Secondary outcomes were length of stay (LOS), total charges (TOTCHG), bleeding, acute kidney injury (AKI), coronary artery bypass grafting (CABG), cardiac arrest (CA), cardiogenic shock (CS), percutaneous coronary intervention (PCI), early PCI (PCI<24hrs) & acute heart failure (AHF).Compared to the non-FM cohort, the FM group had decreased mortality (adjusted odds ratio (aOR): 0.55, CI: 0.44-0.70,p < 0.00), mean TOTCHG (Coefficient -$12768, CI: -$ 15846 -$-9689,p < 0.00), LOS (Coefficient -0.6 days, CI:-0.75 --0.50, p < 0.00), CA (aOR:0.63,CI:0.41-0.88,P<0.01),AHF (aOR:0.70,CI:0.61-0.81,p<0.00)& AKI(aOR:0.71,CI: 0.65-0.77,p<0.00)& increased odds of PCI (aOR:1.15,CI: 1.06-1.23,p<0.00) while odds of CABG (aOR:0.93,CI:0.83-1.04,p<0.20) were decreased.There were increased odds of bleeding (aOR:1.07,CI: 0.83-1.36,p<0.61) & early PCI (aOR:2.25,p<0.45) in FM group but this was statistically insignificant.Conclusions: FM is not associated with worse outcomes in NSTEMI.FM patients had lower in-hospital mortality, LOS & lower charges compared to non-FM patients.They also had higher odds of undergoing PCI & decreased odds of CA, AHF, & AKI.While numerous studies discuss the relationship between CHD & FM, no specific studies mention outcomes in NSTEMI.In our knowledge, this is the first study exploring the interplay between FM & NSTEMI.