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. 2021 Apr 20;16(17):1426-1433.
doi: 10.4244/EIJ-D-20-00935.

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

Oriol Rodriguez-Leor  1 , Ana Belen Cid Alvarez, Armando Pérez de Prado, Xavier Rossello, Soledad Ojeda, Ana Serrador, Ramon López-Palop, Javier Martin-Moreiras, Jose Ramon Rumoroso, Angel Cequier, Borja Ibáñez, Ignatio Cruz-González, Rafael Romaguera, Raúl Moreno
Affiliations

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

Oriol Rodriguez-Leor et al. EuroIntervention. .

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.

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Conflict of interest statement

A. Perez de Prado has received personal fees from iVascular, Boston Scientific, Terumo, B. Braun, and Abbott, outside the submitted work. A. Cequier has received grants and personal fees from Abbott Vascular, Medtronic and Biosensors; grants from Boston Scientific, Biomenco, Cordis, OrbusNeich and Spanish Society of Cardiology; personal fees from Ferrer International, Terumo and AstraZeneca, all outside the submitted work. The other authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Flow chart of patients. STEMI. NSTEMI: non-ST-elevation myocardial infarction; PCR: polymerase chain reaction; STEMI: ST-elevation myocardial infarction
Figure 2
Figure 2
COVID-19 diagnostic status path. Patients were categorised on admission according to their COVID-19 status into four groups: unknown, no symptoms compatible with COVID-19 or previous PCR test, symptoms compatible with COVID-19 but no previous PCR test or previous positive PCR test. Although it is essential to perform a PCR assay at admission in all patients, it should be noted that at the beginning of the pandemic, when this study was carried out, PCR was not available in many facilities. PCR: polymerase chain reaction
Figure 3
Figure 3
In-hospital outcomes. MACE: major adverse cardiovascular events (defined as cardiovascular mortality, non-fatal myocardial infarction or stent thrombosis)
Visual summary
Visual summary
In-hospital outcomes of COVID-19 ST-elevation myocardial infarction patients.
See this image and copyright information in PMC

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