P4676 - Mortality in Patients With Cirrhosis Presenting With Acute Coronary Syndrome and Undergoing Coronary Revascularization: A Systematic Review and Meta-Analysis
Fernando R. Mateo, MD1, Giulia Carvalhal De Almeida Cordeiro, 2, Rohan Sabloak, MD3, Oscar Rivera Maquera, MD4, Amilcar Guaschino Broberg, MD5, M Kenan Rahima, MD1, Mhd Kutaiba Albuni, MD6, Venkata Muddana, MD7 1TriHealth Good Samaritan Hospital, Cincinnati, OH; 2Federal University of Campina Grande, Campina Grande, Paraiba, Brazil; 3Sriwijaya University, Palembang, Sumatera Selatan, Indonesia; 4Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima, Lima, Peru; 5Nassau University Medical Center, East Meadow, NY; 6TriHealth, Doha, Ad Dawhah, Qatar; 7TriHealth, Cincinnati, OH
Introduction: Studies have documented a high prevalence of coronary artery disease (CAD) among cirrhotic patients as well as a high risk of cardiovascular complications and mortality. Limited data exist on the risks of acute coronary syndrome (ACS) in cirrhotic patients undergoing emergent percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG). Therefore, we conducted a systematic review and meta-analysis to evaluate the all-cause mortality in this patient population.
Methods: We performed a comprehensive search for studies published up to June 2024 across PubMed, Embase, and Cochrane Databases. These studies evaluated patients with the diagnosis of cirrhosis presenting with ACS and requiring coronary revascularization. Our outcome of interest was all-cause mortality. Statistical Analysis was performed with RevMan 5.4.1 Software.
Results: Out of 1,514 database results, 5 observational retrospective studies were included. 46,475 with cirrhosis and 1,119,787 non-cirrhotic patients after matching, all presenting with ACS were included. In the cirrhotic vs non-cirrhotic cohorts, the mean age was 65 years vs 66 years, the female population was 35% vs 37% and race was white in 70.6% vs 76.4%. All-cause mortality (OR 2.85, CI 2.14-3.79; P< 0.01; Figure 1) was significantly higher in our cohort of cirrhotic patients undergoing PCI/CABG when compared to non-cirrhotics.
Discussion: Patients with cirrhosis who presented with ACS and required revascularization were typically younger, predominantly male and white. These patients experienced a significantly higher mortality rate after PCI or CABG compared to non-cirrhotic patients undergoing the same procedures.
Figure: Figure 1. There was increased mortality in patients with cirrhosis when compared to those without cirrhosis undergoing PCI/CABG. OR 2.85, CI (2.14-3.79); P<0.01
Note: The table for this abstract can be viewed in the ePoster Gallery section of the ACG 2024 ePoster Site or in The American Journal of Gastroenterology's abstract supplement issue, both of which will be available starting October 27, 2024.
Disclosures:
Fernando Mateo indicated no relevant financial relationships.
Giulia Carvalhal De Almeida Cordeiro indicated no relevant financial relationships.
Rohan Sabloak indicated no relevant financial relationships.
Oscar Rivera Maquera indicated no relevant financial relationships.
Amilcar Guaschino Broberg indicated no relevant financial relationships.
M Kenan Rahima indicated no relevant financial relationships.
Mhd Kutaiba Albuni indicated no relevant financial relationships.
Venkata Muddana indicated no relevant financial relationships.
Fernando R. Mateo, MD1, Giulia Carvalhal De Almeida Cordeiro, 2, Rohan Sabloak, MD3, Oscar Rivera Maquera, MD4, Amilcar Guaschino Broberg, MD5, M Kenan Rahima, MD1, Mhd Kutaiba Albuni, MD6, Venkata Muddana, MD7. P4676 - Mortality in Patients With Cirrhosis Presenting With Acute Coronary Syndrome and Undergoing Coronary Revascularization: A Systematic Review and Meta-Analysis, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.
