ODP143 Cushing Syndrome - A Potential Risk Factor For Atrial Fibrillation

INTRODUCTION: Cushing syndrome (CS) is a systemic disorder characterized by prolonged exposure to high cortisol hormones. Our study analyses the association of Cushing syndrome as a risk factor for atrial fibrillation (A-fib), its effect on associated complications and mortality. METHODS: We conducted a retrospective analysis of 3 years of the National Inpatient Sample (NIS) data base from 2016 to 2018. Patients with Cushing syndrome, in association with/without A-fib were selected using ICD-10 diagnosis code. Discharge-level weight analysis was used to produce a national estimate. We conducted multivariate regression analysis to calculate odds ratio. RESULTS: During the study period 107,024,275 patient met inclusion criteria. 35,309 patient was diagnosed with CS. Mean age of Cushing patients was 52 and non-Cushing patients was 49. History of hypertension, congestive heart failure (CHF) and obstructive sleep apnea (OSA) were more prevalent in CS population (42. 03% v 29.34%, 20.99% vs 14.18, 17.29% v 5.86). Cushing patients had less prevalence of ischemic heart disease (5.10% v 5.91%). After adjusting with age, hypertension, CHF, ischemic heart disease, race and OSA, CS is related with higher prevalence of A-fib (OR 1.13, 1. 03-1.24, p = 0. 014). However it doesn't increase the complications of A-fib. While 3.70% patients with both CS and A-fib developed ischemic stroke, 3.81% patients without Cushing had the ischemic strokes. No arterial embolic events were detected in CS patients with A-fib, but 0.41% of patients without CS had arterial embolism. Univariate regressions demonstrated no significant association between CS and ischemic stroke associated with A-fib (p = 0.898). Our study also demonstrated that CS is related with high in-hospital mortality. When it was adjusted to age, sex, congestive heart failure, ischemic stroke and chronic kidney disease, CS with concomitant A-fib is associated 1.8 times higher mortality (OR 1.8, 1.27- 2.60, p = 0. 001). DISCUSSION: Several studies have demonstrated a possible association between serum cortisol level and the risk of A-fib. To our knowledge, this is the first study to demonstrate CS's clinical significance on A-fib. In our analysis, a statistically significant association was found between A-fib and CS with higher in-hospital mortality reported in patients with CS and concomitant A-fib. Patients with CS tend to have higher CHA2DS2-VASc Score but there is no association with higher risk of complications from A-fib. Our study prompts the need for further research to establish CS as an important risk factor for atrial fibrillation. Presentation: No date and time listed