Abstract

e13740 Background: Hepatocellular carcinoma (HCC) ranks as the 6th most common cancer and as the 3rd leading cause of cancer-related mortality. With immunotherapy improving survival rates, the relevance of major adverse cardiovascular and cerebrovascular events (MACCE) is increasing. We aim to explore the racial disparities in MACCE among patients with HCC, thus leading to a better understanding of the interplay of these conditions with social determinants of health. Methods: Using ICD-10 codes, patients with HCC were identified from National Inpatient Sample 2019 database. We included all-cause in-hospital mortality (ACIHM), acute myocardial infarction (AMI), atrial fibrillation (AF), cerebrovascular accident (CVA), and sudden cardiac death (SCD) as MACCE for the outcomes. Baseline characteristics including demographics, comorbidities; and MACCE outcomes were compared using chi-square for categorical or ANOVA for continuous data (statistical significance determined as p-value <0.05) and results were stratified based on patient’s races. Results: Out of the total sample size of 89,615 patients admitted with a diagnosis of HCC, 60.14% (53,895) were White, 13.67% (12250) were Black, 15.64% (14015) were Hispanic, 6.48% (5805) were Asian/Pacific Islander, 0.8% (720) were Native American, while 3.27% (2930) belonged to other ethnicities. There were significant racial differences in comorbidities with hypertension being most prevalent in Black patients (42.53%), diabetes mellitus in Native American patients (45.14%) and dyslipidemia in Asian/Pacific Islander patients (32.39%). When compared to White patients, ACIHM was the significantly higher in Black patients with adjusted odds ratio (aOR) of 1.305 (95% CI 1.123-1.517, p=0.001), Asian/Pacific Islander patients with aOR 1.271 (95% CI 1.024-1.578, p=0.03) and Other races patients with aOR 1.578 (95% CI 1.2-2.076, p=0.001). AF was significantly lower in all races when compared to White patients. CVA was significantly higher in Black patients with aOR 1.654 (95% CI 1.329-2.059, p<0.001) compared to White patients. SCD was significantly higher in Asian/Pacific Islander patients with aOR 2.22 (95% CI 1.364-3.612, p=0.001) when compared to White patients. https://docs.google.com/document/d/1wM_b0jmNjChKEfpyj5SL6HmSKEhDo0N3X5H76jC-w0I/edit?usp=sharing Conclusions: In patients with HCC, Asian/Pacific Islander patients had higher ACIHM and SCD while Black patients had higher ACIHM and CVA as compared to White patients. This study highlights the importance for development of healthcare strategies stratified by race which may aid to mitigate the higher risk of MACCE in certain races. Further research involving possible genetic influences and social determinants of health contributing to poorer outcomes in people of color becomes imperative.