Introduction: Even after surgical correction, adults with a previously corrected Congenital Heart Disease (CHD) may remain at a significantly elevated risk of arrhythmias. However, there is not much known about the prevalence, comorbidity burden, and impact of arrhythmia in these patients. Methods: Using the National Inpatient Sample (2015 Oct-2017), adult admissions with previously corrected CHD were identified. The primary outcome was the prevalence of arrhythmia and secondary outcomes included comorbidities and outcomes between the arrhythmic vs. non-arrhythmic cohort. Results: Of 19,395 admissions with previously corrected CHD, 7675 (39.6%) patients experienced arrhythmias [median age 55 (39-68) years, male 51.7%, white 75%] (Table 1). The arrhythmic cohort often consisted of relatively older, male, white patients and had higher rates of hypertension (56.4% vs. 41%), hyperlipidemia (33.1% vs. 23%), diabetes (9% vs. 6.5%), renal failure (14% vs. 7.8%), and congestive heart failure (17.6% vs. 9.2%) compared to the non-arrhythmic cohort. The arrhythmic cohort had a higher frequency of patients with at least one CVD risk factor (75.5% vs. 65.4%). All-cause mortality was non-significantly higher in the cohort with arrhythmia (1.6% vs. 1.3%). Furthermore, the arrhythmic cohort was less often routinely discharged and had more frequent transfers/home healthcare requirements, prolonged hospital stay, and higher hospital charges. Conclusions: Nearly 40% of admissions among patients with a prior history of surgically corrected CHD experienced arrhythmias which were associated with a considerably higher comorbidity burden and healthcare resource utilization with non-significantly higher all-cause mortality.

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Introduction: There have been increasing hospitalizations among young adults for peripheral vascular disease (PVD) in the last decade. We compared the mean age of young PVD admissions with cardiovascular comorbidities and major adverse cardiac and cerebrovascular events (MACCE) across two national cohorts 10-years apart. Methods: Two nationwide cohorts from 2007 and 2017 were analyzed for mean age at presentation with CVD risk factors and MACCE in young (18-44 years) PVD hospitalizations. Age at admission was reported as Mean± SD and compared between two groups using student’s t-test. Results: A total of 37,099 admissions in 2007 and 46,760 admissions in 2017 were identified for PVD among young adults. Total admissions increased from 0.4% to 0.5%.The 2017 cohort showed that non-elective PVD admissions occurred at significantly younger age (mean 35 vs 38 years) compared to 2007 cohort. Patients with PVD had comorbid risk factors including hypertension, diabetes mellitus, smoking, obesity, and congestive heart failure (CHF) with a mean age of 39±5 years at presentation in 2007 which decreased to 38±6 years for hypertension and diabetes, 36±6 years for smoking and 37±6 years for CHF and obesity (p<0.001) in 2017. Mean age for MACCE in PVD was 39±5 years in 2007 cohort which significantly reduced to 36±7 years in 2017 (p<0.001) (Table 1). Acute myocardial infarction, cardiogenic shock and PCI procedures were recorded at a younger age in 2017 PVD cohort vs. 2007 PVD cohort. Similarly, the 2017 PVD cohort included relatively younger patients experiencing ventricular tachyarrhythmias and stroke. Conclusions: This study from two young cohorts selected 10-years apart shows increasing trends in PVD hospitalizations occurring at a significantly younger age with associated cardiovascular comorbidities and MACCE in recent years. The link between young age and complicated/severe PVD admissions with frequent comorbidities should be further investigated.

Background: Social determinants of health have an important influence on health equity. Addressing them appropriately is essential to improve population health outcomes and decrease health care disparities. We aimed to compare data from two nationwide cohorts from the US to analyze the shift of cardiovascular risk burden and major adverse cardiac and cerebrovascular events (MACCE) in low-household income (LHI) groups. Methods: Adult admissions among patients from LHI (0-25th) quartile were identified from two cohorts in 2007 and 2017 using the National Inpatient Sample. Socio-demographics, and pre-existing cardiovascular/extra-cardiovascular comorbidities were compared between the cohorts and multivariable regression was performed to assess the risk of MACCE (all-cause mortality, acute myocardial infarction and cardiac arrest including ventricular tachyarrhythmias) in 2017 vs. 2007 cohort. Results: Hospitalizations among LHI quartile showed 12% relative increase in 2017 (N=10,680,030) as compared to 2007(N=9,510,877). The 2017 cohort was younger (mean age 57 to 54 years) and admissions among male patients increased from 39% to 43.6% between 2007 and 2017. Also, non-elective and Medicaid admissions increased from 74% to 81% and 21% to 32%, respectively in 2017. Traditional CVD risk factors and comorbidities in the LHI quartile increased in 2017 compared to 2007 cohort (Table 1). The risk of composite MACCE was higher in the 2017 cohort compared to 2007 cohort (7.2% vs 6.7%, adjusted OR 1.03, 95%CI:1.03-1.04, p<0.001). Although the hospital stay was comparable (3 days), hospitalization charges increased in 2017. Conclusion: Comparative analysis of LHI admissions across a decade shows that increasingly younger, male, non-white patients get hospitalized for non-elective reasons and have a higher burden of CVD risk factors and MACCE in 2017 vs. 2007. This warrants preventive strides to curtail CVD burden in patients of the LHI and improve health outcomes.

Introduction: Pulmonary hypertension (PH) in cancer patients is an underrecognized problem. It can be secondary to malignancy, medications, thromboemboli in lung, and underlying cardiac or lung disease. Outcomes of PH in cancer survivors have not been studied before. The objective of this study is to study the prevalence and impact of Non-group 1 PH on admissions among cancer survivors. Methods: The National Inpatient Sample (October, 2015 to 2017), was used to identify all adult hospitalizations among cancer survivors with PH using ICD-10 codes. Primary outcome were prevalence and demographics of PH in cancer survivors. Secondary outcomes were in-hospital mortality and healthcare resource utilization. Results: Of 6,003,538 weighted nationwide admissions of cancer survivors, 4.7% (282,810) had non-group 1 PH. The prevalence of PH was higher in patients with prior cancers compared to other admissions (4.7% vs. 3.3%, p<0.001). It was higher in females than males (5.1% vs. 4.3%). Most common in blacks (5.9%), followed by whites (4.7%), Native American (4.1%), Asian or Pacific Islander (3.8%), others (3.7%) and Hispanics (3.3%) (Fig. 1) . Hypertension, Diabetes, smoking, obesity, renal failure, congestive heart failure, valvular heart disease and chronic pulmonary disease were higher in PH group. In-hospital outcomes in cancer survivors with vs. without PH showed significantly higher all-cause inpatient mortality in PH group (OR1.34, 95% CI=1.31-1.37, p<0.001) with fewer routine discharges (39.3% vs. 52.1%, p<0.001), higher transfer rate to short-term hospital, and other facilities (skilled nursing care/intermediate care facility), higher home health care requirement, prolonged hospital stay (4 vs 3 days), and higher cost ($10,325 vs. $9163) per admission. Conclusion: This is the first large-scale study to demonstrate the higher burden and worse in-hospital outcomes of non-group 1 PH in cancer survivors. Early diagnosis and treatment is necessary.