0991 Narcolepsy and In-Hospital Outcomes Following Acute Myocardial Infarction: A National Inpatient Sample Study

Abstract Introduction Narcolepsy has been associated with increased cardiovascular and cardiometabolic risk. However, limited data exist regarding its impact on acute coronary artery disease, particularly ST-elevation myocardial infarction (STEMI). Methods Using the National Inpatient Sample (NIS) database from 2016–2021, we identified adults (≥18 years) hospitalized with a primary diagnosis of STEMI (ICD-10: I21.0–I21.3). Patients were stratified by the presence of narcolepsy (ICD-10: G47.41, G47.419). Outcomes of interest included in-hospital mortality, length of stay (LOS), and total hospitalization charges. Multivariable logistic and linear regression models were used to evaluate associations, adjusting for age, sex, race, primary payer, comorbidities, and year. Results Narcolepsy was present in 100 patients (0.04%). Compared with patients without narcolepsy, those with narcolepsy had lower in-hospital mortality (7.0% vs. 11.1%), shorter LOS (4.1 vs. 4.7 days), and lower total charges ($98,571 vs. $127,407), although none of these differences were statistically significant. In adjusted analyses, narcolepsy was not significantly associated with in-hospital mortality (OR 0.69; 95% CI 0.32–1.48; p=0.340), LOS (β −0.50 days; 95% CI −1.32 to 0.31; p=0.226), or hospitalization charges (−2% on average; 95% CI −15% to +11%; p=0.739). Conclusion Narcolepsy was not independently associated with in-hospital mortality, LOS, or hospital costs after adjustment for clinical and demographic factors. These findings suggest that, despite the known long-term cardiometabolic risks associated with narcolepsy, its presence does not appear to worsen short-term outcomes during acute myocardial infarction. Support (if any)