(168) HOCM: Does Pulmonary Hypertension Worsen Outcomes in This Population?

Introduction: Hypertrophic Obstructive Cardiomyopathy (HOCM) with concomitant Pulmonary Hypertension (PH) presents unique clinical challenges. This study aims to elucidate the demographic, clinical, and comorbidity profiles of HOCM patients with and without PH and to evaluate the impact of PH on in-hospital mortality.

Methods: Using the National Inpatient Sample (NIS) from 2016-2021, we analyzed a weighted sample of 333,505 HOCM patients. Of these, 44,375 (13.3%) had PH, and 289,130 (86.7%) did not. Statistical comparisons were made using chi-square tests for categorical variables and t-tests for continuous variables. Multivariate logistic regression was performed to identify predictors of in-hospital mortality.

Results: In-hospital mortality was significantly higher in the PH group (5.1% vs. 3.3%, p< 0.001). Multivariate analysis identified PH as an independent predictor of mortality (adjusted OR 1.203, p=0.003). Other predictors included age ≥65 years (adjusted OR 2.914, p< 0.001), chronic heart failure (adjusted OR 1.467, p< 0.001), COPD (adjusted OR 1.157, p< 0.001), liver disease (adjusted OR 3.435, p< 0.001), CKD/ESRD (adjusted OR 1.468, p< 0.001), pneumonia (adjusted OR 2.86, p< 0.001), and COVID-19 (adjusted OR 2.719, p< 0.001).

Conclusions: HOCM patients with PH represent a distinct cohort with higher comorbidity burden and increased in-hospital mortality. Age, chronic heart failure, COPD, liver disease, CKD/ESRD, pneumonia, and COVID-19 significantly impact mortality in these patients. Enhanced management strategies are warranted to address these risks in HOCM patients with PH.