Abstract: TH-PO633
ESKD as a Risk Factor for Acute Coronary Syndrome in Younger Patients
Session Information
- Hypertension and CVD: Epidemiology, Risk Factors, Prevention
November 03, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
Abstract Time: 10:00 AM - 12:00 PM
Category: Hypertension and CVD
- 1501 Hypertension and CVD: Epidemiology‚ Risk Factors‚ and Prevention
Authors
- Whittier, Millan L., Rush University Medical Center, Chicago, Illinois, United States
- Oliveira, Meloney, Rush University Medical Center, Chicago, Illinois, United States
- Manadan, Augustine, Rush University Medical Center, Chicago, Illinois, United States
Background
End-stage kidney disease (ESKD) is a known risk factor for cardiovascular (CV) disease including acute coronary syndrome (ACS), arrhythmias and congestive heart failure. ESKD patients are at higher risk of CV related mortality compared to the general population. There is presently a paucity of population-based studies of ESKD as a risk factor for ACS in young patients. We aimed to compare the presence of ACS in hospitalized patients aged 18-40 to patients >40 years with and without ESKD while controlling for traditional CV risk factors.
Methods
Data was extracted from the 2016-2019 US National Inpatient Sample (NIS) database. Hospitalizations of adult patients with ACS as the principal diagnosis, with and without ESKD as the secondary diagnosis were evaluated. Age was divided categorically into 2 groups: adults 18-40 and >40 years. The primary outcome was the development of ACS. MV logistic regression analysis was used to adjust for confounders.
Results
There were 121,099,120 adult hospital discharges in 2016-2018 NIS database. Of those, 74,225 between 18-40 and 2,626,129 >40 years were hospitalized with a principal diagnosis of ACS. Traditional CV risk factors were associated with ACS hospitalizations in both age groups. In MV analysis of the 18-40 age group, the odds ratio (OR) for ESKD was 1.24 (P<0.001) (Table 1). Above the age 40, the OR for ESKD was 0.95 (P<0.001) (Table 1).
Conclusion
In younger patients, ESKD was strongly associated with ACS hospitalization in addition to the traditional CV risk factors. In the older group, traditional CV risk factors predominated in the association with ACS.
Multivariate Analysis of CV Risk Factors
| Variables | ACS between ages 18 to 40 | ACS in greater than age 40 | ||||
| Odds Ratio | P-Value | 95% Confidence Interval | Odds Ratio | P-value | 95% Confidence Interval | |
| Diabetes | 1.22 | <0.001 | 1.166-1.287 | 1.17 | <0.001 | 1.159-1.177 |
| Hypertension | 2.33 | <0.001 | 2.256-2.435 | 0.95 | <0.001 | 0.942-0.957 |
| Hyperlipidemia | 10.42 | <0.001 | 9.917-10.953 | 2.69 | <0.001 | 2.668-2.721 |
| Obesity | 1.97 | <0.001 | 1.890-2.047 | 1.09 | <0.001 | 1.080-1.103 |
| Smoker | 2.52 | <0.001 | 2.426-2.612 | 1.71 | <0.001 | 1.700-1.729 |
| ESKD | 1.24 | <0.001 | 1.118-1.366 | 0.95 | <0.001 | 0.931-0.961 |
| Female | 0.30 | <0.001 | 0.288-0.312 | 0.61 | <0.001 | 0.607-0.615 |
| African American | 1.00 | 0.938 | 0.892-1.132 | 0.67 | <0.001 | 0.649-0.707 |
| White | 0.90 | 0.079 | 0.802-1.012 | 0.86 | <0.001 | 0.824-0.894 |
| Hispanic | 0.78 | <0.001 | 0.692-0.886 | 0.87 | <0.001 | 0.829-0.907 |
| Asian and Pacific Islander | 1.13 | 0.126 | 0.967-1.310 | 1.05 | 0.061 | 0.998-1.104 |
| Other Race | 1.00 | 0.963 | 0.869-1.159 | 1.01 | 0.734 | 0.954-1.069 |