P157 AORTIC CALCIFICATIONS AND INFLAMMATION ARE ASSOCIATED WITH IN-HOSPITAL COMPLICATIONS IN ACUTE CORONARY SYNDROME

Abstract

Purpose/Background/Objectives: Aortic calcifications and inflammation are independent predictors of adverse cardiovascular events. We sought to investigate the association of aortic calcifications and inflammation with in-hospital morbidity and mortality of patients with acute coronary syndrome (ACS). Methods: Two hundred patients (mean age 66 ± 15 years, 150 males) admitted to our Hospital with ACS from 2016-2017 were included in the study. The extent of aortic arch calcification (AAC) on a postero-anterior plain chest X-ray was divided into four grades (0 to 3). Grades 0 to 1 and grades 2 to 3 were categorized as lower and higher AAC grade respectively. High-sensitivity C-reactive protein (hsCRP) was also assessed. In-hospital complications that included reinfarction, arrhythmias, heart failure, stroke, mechanical complications, renal failure, surgery and death were assessed in all patients. Results: The majority of patients (n = 132, 66%) presented with non-ST elevation ACS, whereas 68 patients as ST-elevation myocardial infarction (STEMI) (n = 68, 34%). Seventy-seven (38.5%) patients presented with one or more in-hospital complications (6 of them died). Higher AAC grade was visible in 44 patients (22%). Patients with higher AAC had increased risk (Odds ratio [OR] = 2.29, 95% Confidence intervals [CI] 1.03 to 5.12, p = 0.043) for in hospital complications after adjusting for age, gender, STEMI/NSTE-ACS diagnosis (OR = 4.10, 95% CI 2.08 to 8.05 for STEMI diagnosis, p < 0.001) and hsCRP (OR = 1.80, 95% CI 1.10 to 2.93, p = 0.02). Conclusions: Our study shows that simple tools can be used to assess the in-hospital risk of ACS patients. It also highlights the prognostic role of arterial stiffness and low-grade inflammation in ACS.