P4338 - Paradoxical Effect of Inflammatory Bowel Disease on Inpatient Mortality Following Coronary Artery Bypass Graft Surgery: A Nationwide Analysis

Muhammad Jahanzaib Khan, MD¹, Shahan Haseeb, MD², Hameed Ullah, MD³, Monica Arora, MD², Maryam Salma. Babar, MD⁴, Ramona Rajapakse, MD^2
1Mather Hospital, Northwell Health, New York, NY; ²Mather Hospital, Northwell Health, Port Jefferson, NY; ³Saint Luke's Hospital, St. Louis, MO; ⁴Cleveland Clinic, Abu Dhabi, Abu Dhabi, United Arab Emirates

Introduction: Inflammatory bowel disease (IBD) is a chronic inflammatory disorder. Systemic inflammation increases the risk of atherosclerosis. Existing studies reveal an elevated risk of atherosclerosis and coronary artery disease (CAD) in IBD patients compared to those without IBD. However, the impact of IBD on outcomes following coronary artery bypass grafting (CABG) remains understudied. We aim to assess whether IBD influences inpatient mortality after CABG.

Methods: We utilized the National Inpatient Sample (2018-2020), sampling 530,755 patients who underwent CABG using ICD-10 PCS codes. Patients with IBD were identified using ICD-10 codes for Crohn’s Disease (CD) and Ulcerative Colitis (UC). Mann-Whitney U and Chi-square tests were performed for numeric and categorical variables, respectively. Weighted samples were used.

Results: There were a total of 2785 patients with IBD in the included population who underwent CABG. The median age of the patients with IBD was found to be 68 years (IQR: 62-74). Baseline characteristics of the patients in the two groups are described in Table 1. Both groups exhibit comparable Length of Stay (median 8 days, IQR: 6-11 for IBD, and median 8 days, IQR: 6-12 for non-IBD, p = 0.71 and p = 0.34, respectively). In terms of comorbidities, the prevalence of Type 2 Diabetes (28.37% vs. 34.80%, p < 0.05) and Congestive Heart Failure (22.44% vs. 28.39%, p < 0.05) is significantly lower in the IBD group compared to the non-IBD group. Adjusted logistic regression analysis revealed a protective effect. Interestingly, patients with IBD had a 68% lower association with inpatient mortality than those without IBD (OR = 0.32, p = 0.01).

Discussion: We hypothesize that the observed decreased mortality following CABG in patients with IBD may be attributed to alterations in immunity, possibly influenced by anti-inflammatory and immunomodulating medications that are commonly administered to a majority of patients with IBD. Moreover, the prevalence of Type 2 Diabetes and Congestive Heart Failure was higher in the non-IBD group, likely contributing to higher inpatient mortality in that group. Alternatively, unexplained intrinsic factors and various selection biases inherent in administrative data may confer protective effects in the setting of CABG. Despite these promising findings, individual variations exist, emphasizing the need for further research to comprehensively understand the complex interconnections between IBD, cardiovascular health, and surgical interventions.


Disclosures:


Muhammad Jahanzaib Khan, MD¹, Shahan Haseeb, MD², Hameed Ullah, MD³, Monica Arora, MD², Maryam Salma. Babar, MD⁴, Ramona Rajapakse, MD². P4338 - Paradoxical Effect of Inflammatory Bowel Disease on Inpatient Mortality Following Coronary Artery Bypass Graft Surgery: A Nationwide Analysis, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.