Journal of CardioVascular Insights

Abstract

Background: Heart failure (HF) is associated with increased peri-procedural risk, yet outcomes following en doscopic retrograde cholangiopancreatography (ERCP) across HF phenotypes remain poorly defined. Given the distinct pathophysiology of HF with preserved ejection fraction (HFpEF) and reduced ejection fraction (HFrEF), we compared post-ERCP outcomes between these groups using a national inpatient database.

Methods: We conducted a retrospective cohort study using the Nationwide Inpatient Sample from 2016–2020. Adult hospitalized patients with HF who underwent ERCP were identified using ICD-10 codes and stratified into HFpEF and HFrEF. The primary outcome was in-hospital mortality. Secondary outcomes included acute HF exacerbation, acute coronary syndrome (ACS), cardiac arrest, cardiogenic shock, intubation, acute res piratory failure, and acute kidney injury (AKI). Multivariable logistic regression adjusted for de-mographics, hospital characteristics, and comorbidities.

Results: Among 9,765 patients with HF undergoing ERCP, 5,848 had HFpEF and 3,917 had HFrEF. Patients with HFpEF were older (77.1 vs. 74.0 years) and more frequently female (55.6% vs. 34.8%) (both p

Conclusions: Patients with HFrEF undergoing ERCP experience higher rates of serious post-procedural com plications despite similar in-hospital mortality, underscoring the need for HF phenotype–specific peri-proce dural risk stratification.