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In-hospital outcomes of COVID-19 ST-elevation myocardial infarction patients

Oriol Rodríguez‐Leor, Ana Belén Cid Álvarez, Armando Pérez de Prado, Xavier Rosselló, Soledad Ojeda, Ana Serrador, Ramón López‐Palop, Javier Martín‐Moreiras, José Ramón Rumoroso, Ángel Cequier, Borja Ibáñez, Ignacio Cruz‐González, Rafael Romaguera, Raúl Moreno

2021EuroIntervention92 citationsDOIOpen Access PDF

Abstract

AIMS: The aim of this study was to assess clinical and prognosis differences in patients with COVID-19 and STEMI. METHODS AND RESULTS: Using a nationwide registry of consecutive patients managed within 42 specific STEMI care networks, we compared patient and procedure characteristics and in-hospital outcomes in two different cohorts, according to whether or not they had COVID-19. Among 1,010 consecutive STEMI patients, 91 were identified as having COVID-19 (9.0%). With the exception of smoking status (more frequent in non-COVID-19 patients) and previous coronary artery disease (more frequent in COVID-19 patients), clinical characteristics were similar between the groups, but COVID-19 patients had more heart failure on arrival (31.9% vs 18.4%, p=0.002). Mechanical thrombectomy (44% vs 33.5%, p=0.046) and GP IIb/IIIa inhibitor administration (20.9% vs 11.2%, p=0.007) were more frequent in COVID-19 patients, who had an increased in-hospital mortality (23.1% vs 5.7%, p<0.0001), that remained consistent after adjustment for age, sex, Killip class and ischaemic time (OR 4.85, 95% CI: 2.04-11.51; p<0.001). COVID-19 patients had an increase of stent thrombosis (3.3% vs 0.8%, p=0.020) and cardiogenic shock development after PCI (9.9% vs 3.8%, p=0.007). CONCLUSIONS: Our study revealed a significant increase in in-hospital mortality, stent thrombosis and cardiogenic shock development after PCI in patients with STEMI and COVID-19 in comparison with contemporaneous non-COVID-19 STEMI patients.

Topics & Concepts

MedicineCardiogenic shockInternal medicineMyocardial infarctionConventional PCICardiologyPercutaneous coronary interventionKillip classCoronavirus disease 2019 (COVID-19)ThrombosisCoronary artery diseaseDiseaseInfectious disease (medical specialty)COVID-19 and healthcare impactsCOVID-19 Clinical Research StudiesAcute Myocardial Infarction Research