Abstract 14455: Outcomes and Revascularization Strategies for ST Elevation Myocardial Infarction in Patients With Hypertrophic Cardiomyopathy

Introduction: Myocardial ischemia is a well-known complication of hypertrophic cardiomyopathy (HCM). There are limited contemporary data on outcomes and revascularization strategies of STEMI outcomes in HCM. Methods: The National Inpatient Sample 2004-2018 was queried to identify adult patients presenting with a primary diagnosis of STEMI. Patients with STEMI and a concomitant diagnosis of HCM were subsequently identified. Complex samples multivariable logistic and linear regression models were used to determine the association of HCM with in-hospital outcomes (all-cause mortality, invasive mechanical ventilation, cardiogenic shock, mechanical circulatory support, and cardiac arrest). Outcomes of HCM patients with STEMI who were revascularized were also compared with their counterparts who were not revascularized. Results: Of 3,049,068 primary STEMI hospitalizations included within this study, 2,583 (0.8%) had an associated diagnosis of HCM. HCM patients were more likely to be elderly and female with less traditional cardiovascular risk factors compared to those without HCM. HCM patients were also less likely to receive percutaneous coronary intervention compared to those without HCM (42.8% 66.3% vs. P<0.001). STEMI with HCM was associated with similar in-hospital mortality (adjusted odds ratio [aOR] 1.09; 95% confidence interval [CI] 0.82-1.44; P=0.561) and other outcomes compared to those without HCM (Table 1) . Notably, STEMI patients with HCM who were revascularized had similar in-hospital mortality (aOR 0.69; 95% CI 0.36-1.33; P=0.266) compared to their HCM counterparts who did not receive revascularization. Conclusions: Despite lower rates of revascularization, STEMI with HCM is associated with similar in-hospital mortality compared to those without HCM.