A regression was introduced with https://github.com/clojure/clojurescript/commit/1a537e57a1fda9ac54f86ed4a88e92713aefdb36 where the optimization is overly aggressive in the case of invoking sets on values returned by Node calls.
Note that in the above, this can be worked around by suppressing the optimization with an ^any hint.
Using the parent commit SHA shows that things were fine prior to this commit of interest:
This issue was discovered via Canary for the Hoplon project which has a similar expression 
No longer broken with latest commits on master.