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. 2023 Nov-Dec;74(10):987-996.
doi: 10.1177/00033197221129351. Epub 2022 Oct 12.

SARS-CoV-2 Positivity, Stent Thrombosis, and 30-day Mortality in STEMI Patients Undergoing Mechanical Reperfusion

Giuseppe De Luca  1 , Magdy Algowhary  2 , Berat Uguz  3 , Dinaldo C Oliveira  4 , Vladimir Ganyukov  5 , Zan Zimbakov  6 , Miha Cercek  7 , Lisette Okkels Jensen  8 , Poay Huan Loh  9 , Lucian Calmac  10 , Gerard Roura I Ferrer  11 , Alexandre Quadros  12 , Marek Milewski  13 , Fortunato Scotto Di Uccio  14 , Clemens von Birgelen  15   16 , Francesco Versaci  17 , Jurrien Ten Berg  18 , Gianni Casella  19 , Aaron Wong Sung Lung  20 , Petr Kala  21 , José Luis Díez Gil  22 , Xavier Carrillo  23 , Maurits Dirksen  24 , Victor M Becerra-Munoz  25 , Michael Kang-Yin Lee  26 , Dafsah Arifa Juzar  27 , Rodrigo de Moura Joaquim  28 , Ciro De Simone  29 , Davor Milicic  30 , Periklis Davlouros  31 , Nikola Bakraceski  32 , Filippo Zilio  33 , Luca Donazzan  34 , Adriaan Kraaijeveld  35 , Gennaro Galasso  36 , Lux Arpad  37 , Lucia Marinucci  38 , Vincenzo Guiducci  39 , Maurizio Menichelli  40 , Alessandra Scoccia  41 , Aylin Hatice Yamac  42 , Kadir Ugur Mert  43 , Xacobe Flores Rios  44 , Tomas Kovarnik  45 , Michal Kidawa  46 , Josè Moreu  47 , Vincent Flavien  48 , Enrico Fabris  49 , Iñigo Lozano Martínez-Luengas  50 , Marco Boccalatte  51 , Francisco Bosa Ojeda  52 , Carlos Arellano-Serrano  53 , Gianluca Caiazzo  54 , Giuseppe Cirrincione  55 , Hsien-Li Kao  56 , Juan Sanchis Forés  57 , Luigi Vignali  58 , Helder Pereira  59 , Stephane Manzo-Silbermann  60 , Santiago Ordoñez  61 , Alev Arat Özkan  62 , Bruno Scheller  63 , Heidi Lehtola  64 , Rui Teles  65 , Christos Mantis  66 , Ylitalo Antti  67 , João António Brum Silveira  68 , Ivan Bessonov  69 , Rodrigo Zoni  70 , Stefano Savonitto  71 , George Kochiadakis  72 , Dimitrios Alexopoulos  73 , Carlos E Uribe  74 , John Kanakakis  75 , Benjamin Faurie  76 , Gabriele Gabrielli  77 , Alejandro Gutierrez Barrios  78 , Juan Pablo Bachini  79 , Alex Rocha  80 , Frankie Chor-Cheung Tam  81 , Alfredo Rodriguez  82 , Antonia Anna Lukito  83 , Anne Bellemain-Appaix  84 , Gustavo Pessah  85 , Giuliana Cortese  86 , Guido Parodi  87 , Mohammed Abed Burgadha  88 , Elvin Kedhi  89 , Pablo Lamelas  90 , Harry Suryapranata  91 , Matteo Nardin  92 , Monica Verdoia  93
Affiliations
Free article

SARS-CoV-2 Positivity, Stent Thrombosis, and 30-day Mortality in STEMI Patients Undergoing Mechanical Reperfusion

Giuseppe De Luca et al. Angiology. 2023 Nov-Dec.
Free article

Abstract

SARS-Cov-2 has been suggested to promote thrombotic complications and higher mortality. The aim of the present study was to evaluate the impact of SARS-CoV-2 positivity on in-hospital outcome and 30-day mortality in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI) enrolled in the International Survey on Acute Coronary Syndromes ST-segment elevation Myocardial Infarction (ISACS-STEMI COVID-19 registry. The 109 SARS-CoV-2 positive patients were compared with 2005 SARS-CoV-2 negative patients. Positive patients were older (P = .002), less often active smokers (P = .002), and hypercholesterolemic (P = .006), they presented more often later than 12 h (P = .037), more often to the hub and were more often in cardiogenic shock (P = .02), or requiring rescue percutaneous coronary intervention after failed thrombolysis (P < .0001). Lower postprocedural Thrombolysis in Myocardial Infarction 3 flow (P = .029) and more thrombectomy (P = .046) were observed. SARS-CoV-2 was associated with a significantly higher in-hospital mortality (25.7 vs 7%, adjusted Odds Ratio (OR) [95% Confidence Interval] = 3.2 [1.71-5.99], P < .001) in-hospital definite in-stent thrombosis (6.4 vs 1.1%, adjusted Odds Ratio [95% CI] = 6.26 [2.41-16.25], P < .001) and 30-day mortality (34.4 vs 8.5%, adjusted Hazard Ratio [95% CI] = 2.16 [1.45-3.23], P < .001), confirming that SARS-CoV-2 positivity is associated with impaired reperfusion, with negative prognostic consequences.

Keywords: STEMI; outcome; thrombosis.

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Conflict of interest statement

Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.