Prevalence and in-hospital outcomes of cardiac events in vitamin b12 deficiency anemia: a national inpatient database analysis

SESSION TITLE: Cardiovascular Disease Posters 5 SESSION TYPE: Original Investigation Posters PRESENTED ON: 10/11/2023 12:00 pm - 12:45 pm PURPOSE: In the US, 20% of adults over 60 years have vitamin B12 deficiency. It causes higher homocysteine levels further leading to increased coronary events. However, little is known about its association with other cardiac conditions including heart failure (HF) and atrial fibrillation (AF). We aim to study its association with various other cardiac events. METHODS: The NIS 2020 was queried for the adult population (age>18 years) with a primary or secondary diagnosis of Vit B12 deficiency. Prevalence of cardiovascular risk factors were compared between patients with and without Vit b12 deficiency. The association of cardiac diagnoses including AF, coronary artery disease (CAD), and HF was analysed. Multivariate regression analysis was performed taking all-cause mortality as a primary outcome and total cost of hospital stay as a secondary outcome. RESULTS: A total of 36415 adult patients with a primary or secondary diagnosis of vitamin B12 deficiency were identified. Mean age was 69 years and 62% of the patients were females. In adult population without B12 deficiency, patients with an underlying deficiency were found to have an increased association with DM (29.0% vs 25.6%; P<0.0001), HTN (32.7% vs 31.2%; P=0.01), HLD (45.2% vs 34.9%) and tobacco abuse (25.2% vs 23.3%; p<0.0001) while obesity was less prevalent in them (17.9% vs 18%; p=0.85) The prevalence of CAD (24.1% vs 18.9%; p<0.0001) , AF (16.0% vs 11.7%; p<0.0001) and HF (55.1% vs 38.5%; p<0.0001) was also found to be significantly higher in patients with underlying B12 deficiency. In the subpopulation of adult patients with B12 deficiency, approximately 2.7% of patients died. However, the odds of mortality was significantly increased if patients had underlying AF (OR- 1.74; C.I.- 1.226-2.488; p=0.002) or ACS (OR- 3.43; C.I.: 2.097- 5.615; p<0.0001). There was no statistically significant increased mortality with HF (p=0.293). In terms of hospital resource utilisation, there was a noteworthy increase in mean total hospital charges in patients with B12 deficiency and underlying AF (6295$; p=0.016) or ACS (32170$; p<0.0001). CONCLUSIONS: In our study, vitamin B12 deficiency was associated with higher prevalence of CAD, HF and AF. The odds of mortality also increased if B12 deficient patients had underlying AF or if they developed ACS. CLINICAL IMPLICATIONS: Vitamin b12 deficiency given its high prevalence, easy reversibility and potential to cause worse outcomes should be further studied in various cardiac conditions like ACS, CAD, and AF to study its impact and potentially prevent it. DISCLOSURES: No disclosure on file for Cesar Ayala Rodriguez No relevant relationships by Dishang Bhavsar No relevant relationships by Pradeep Kumar Devarakonda No relevant relationships by Vishal Dhulipala No relevant relationships by Sukhjeet Kaur No relevant relationships by Suganya Manoharan No relevant relationships by Dhairya Nanavaty No relevant relationships by Saikrishna Patibandla No relevant relationships by Sarath Reddy No relevant relationships by Ankushi Sanghvi No disclosure on file for Sohrab Singh No relevant relationships by RISHAV Sinha