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Background Complete atrioventricular block is a rare, yet important complication that can be seen in some cases of NSTEMI, leading to multiple nefarious complications. Such patients often require permanent pacemaker(PPM) implantations and there is limited data on whether the outcomes are modified by the sex of the patients. We aim to study any sex-based differences in outcomes among non-revascularized NSTEMI patients who underwent PPM implantations after experiencing complete atrioventricular block.Methods NSTEMI patients who did not undergo CABG or PCI and experienced complete AV block requiring permanent pacemaker implantation were studied using the 2016–2021 National Inpatient Sample. We excluded cases with prior PPM implants and younger than 18 years. Multivariable regression analyzes were derived to estimate differences in outcomes between Males and Females.Results We evaluated 1935 cases that matched our selection criteria, consisting of 990(51.2%) Males and 945(48.8%) Females. Males were younger (median age 77.0 vs. 79.0, p<0.01), with no differences in median Charlson Comorbidity Index (CCI) scores(4.0vs. 4.0, p=0.062) or time from admission to procedure(3.0 vs. 3.0 days, p=0.481). Males expressed higher odds of sepsis(aOR 2.173 95% CI 1.336–3.535 p 0.002), need for cardiopulmonary resuscitation(aOR 3.25 95% CI 1.826–5.785 p <0.001), acute kidney injury(aOR 3.715 95% CI 1.203–11.474 p 0.023 ) requiring hemodialysis, and mechanical ventilation(aOR 1.65 95% CI 1.185–2.297 p 0.003), than females. Although their median lengths of stay (6.0 vs. 7.0 days, p=0.249), hospital charges ($113762 vs. $118430, p=0.062), odds of acute ischemic strokes(aOR 1.127 95% CI 0.7–1.815 p 0.623), cardiogenic shock(aOR 0.806 95% CI 0.585–1.11 p 0.187), and need for vasopressors(aOR 1.198 95% CI 0.667–2.153 p 0.546) did not differ, males were more likely to die(aOR 1.757 95% CI 1.048–2.947 p 0.033)( table 1).Abstract 2-018 Table 1(enter this manually) Outcomes in Males (vs. Females, reference) p-value aOR lower upper Death 0.0331.7571.0482.947Cardiogenic shock0.1870.8060.5851.11AIS0.6231.1270.71.815Mech vent0.0031.651.1852.297Aki req hd0.0233.7151.20311.474Cpr<.0013.251.8265.785Vasopressors0.5461.1980.6672.153Sepsis0.0022.1731.3363.535MajorBleeding0.1310.8480.6851.05Conclusion Males undergoing PPM implantation following complete AV block in NSTEMI events are associated with several poorer outcomes than females. This highlights the need for proper pre-operative risk stratification and the need to address post-operative complications promptly for optimal outcomes.