Introduction: Kidney transplantation has been associated with increased cardiovascular risk but the national epidemiology of acute myocardial infarctions (AMI) and percutaneous interventions (PCI) has not been described in liver transplant hospitalizations

Methods: We reviewed the Healthcare Cost and Utilization Project's Nationwide Inpatient Sample database from 2006 to 2012 for liver transplant hospitalizations using validated International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes. We then calculated the proportion of hospitalizations due to AMI and procedure utilization of PCI. We used Cochrane-Armitage trend test to analyze changes in trends and multivariable logistic regression to compare adjusted odds ratios (aOR) of mortality compared to non-transplant AMI hospitalizations.

Results: From 2006-2012, there were 226049 hospitalizations with liver transplant status (LTS). Mean age was 62 years, 72% were male and 78.7% were White. Of these, 2235 (0.98%) were hospitalized with AMI and 1037(0.45%) received PCI. In trend analysis, the proportion of hospitalizations with AMI was unchanged over the study period (0.87% in 2006 to 1.15% in 2012; p=0.56); but utilization of PCI increased (0.33% in 2006 to 0.56% in 2012; p= 0.001). After adjusting for confounders, LTS was not associated with increased odds for in-hospital mortality compared to non-transplant hospitalizations either overall (aOR 1.09; 95% CI 0.85-1.40; p=0.47) or among those receiving PCI (aOR 1.13; 95% CI 0.51-2.53; p=0.29).

Conclusions: The proportion of liver transplant hospitalizations with AMI has remained stable, but PCI rate among LTS patients has doubled nationally from 2006-2012 without increased mortality compared to non-transplant AMI hospitalizations. The increase in PCI may reflect an aging transplant population with increasing cardiovascular disease severity including longer post-transplant survival, or improved screening. Our results suggest the need for further analyses to better describe the causes and implications of these trends.

CITATION INFORMATION: Nadkarni G, Menon M, Kent R, Patel S, Patel A, Schiano T, Florman S, Heeger P. National Trends of Acute Myocardial Infarction and Percutaneous Interventions in Liver Transplant Hospitalizations from 2006-2012. Am J Transplant. 2016;16 (suppl 3).

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