Nothing to disclose.

Heart failure (HF) and meta-bolic syndrome (MetS) are commonly co- exist. MetS are known to be one of the risk factors of HF, and it can also act as a comorbidity in HF. Mets is an independent risk factor for cardiovascular disease, however its impact on HF outcomes is incompletely understood.

We sought to determine the 30-Day Readmission rate (30-DRr) of patients with Acute Congestive Heart Failure (aCHF) & Co-existing Metabolic Syndrome (MetS) & its impact on mortality, clinical outcomes & healthcare utilization in the United States.

Using the 2017 & 2018 National Readmission Database, we conducted a retrospective analysis of patient discharges with aCHF as a principal diagnosis & MetS as a secondary diagnosis according to ICD-10 codes. Readmission was defined as the first admission to any hospital for any non-trauma diagnosis within 30 days of the index admission. Same-day admissions & discharges were excluded. The primary outcome was 30DRr, while secondary outcomes were readmission mortality rate, most common diagnoses (MCD's) for readmission, & resource utilization defined by length of stay (LOS), Average & Total Patient Charge (TPC), & Average and Total Hospital Cost (THC).

A total of 530 index hospitalization for aCHF with co-existing MetS. Index vs. Readmission Cohorts had a mean age of 62.2 years vs. 60.6 years, Males (51.6% vs. 61.1%). In- hospital mortality rate for index admission was 1.7%, while 30-DRr was 13.6% (Figure 1).

Among this group of readmitted patients, in-hospital mortality rate was 2.2%, compared to index admission (2.2% vs. 1.7%, adjusted p-value=0.1). The total hospital days associated with readmission were 460 days, with a THC of $1,144,028 & TPC of $3,555,453.

In patients with aCHF & MetS, we observed a high readmission rate of ∼1 in 7 readmitted. There was subsequent higher mortality with the readmitted patient, but this was not statistically significant. Heart Failure, Acute Kidney Injury, Atrial Fibrillation, ASCVD were the most common reasons for readmission and were associated with a higher economic health care burden. A higher risk for hypertensive heart failure among MetS patients & a more significant proportion of patients with CKD & AF may indicate a higher risk for HFpEF. Comprehensive management involving a multidisciplinary team is necessary for managing patients with metabolic syndrome and heart failure to help alleviate the health care burden. Further research focusing on the HF subtypes among MetS & HF is needed to help understand specific patient populations at risk & thereby help alleviate the health care burden.