Angiographic and clinical outcome of SARS-CoV-2 positive patients with ST-segment elevation myocardial infarction undergoing primary angioplasty: A collaborative, individual patient data meta-analysis of six registry-based studies

Luca, Giuseppe De; Silverio, Angelo; Verdoia, Monica; Siudak, Zbigniew; Tokarek, Tomasz; Kite, Thomas A; Gershlick, Anthony; Rodriguez-Leor, Oriol; Cid-Álvarez, Belén; Jones, D A; Rathod, Krishnaraj S.; Cabezas, José M. Montero; Jurado-Román, Alfonso; Nardin, Matteo; Galasso, Gennaro

doi:10.1016/j.ejim.2022.08.021

Cited by 8 publications

(6 citation statements)

References 39 publications

(82 reference statements)

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“… 141 Data from European registries showed similar findings including prolonged door to balloon times, significantly increased rates of in-hospital mortality, and suboptimal postprocedural TIMI flow in STEMI patients with active COVID-19 undergoing primary PCI. 144 Results from the International COVID-ACS registry were again consistent with the aforementioned registry data emphasizing increased in-hospital mortality, cardiogenic shock, and prolonged door to balloon times. 145 , 146 Using the NACMI registry, a weighted integer risk score was developed using readily available clinical data at time of STEMI presentation in patients with COVID-19 (respiratory rate >35, prePCI shock, hypoxia, age >55, infiltrates on chest x-ray, creatinine >1.5, diabetes, subjective dyspnea) to accurately predict in-hospital mortality.…”

Section: Acute Coronary Syndromes and Cardiac Catheterization Laborat...supporting

confidence: 75%

Interaction of COVID-19 With Common Cardiovascular Disorders

Boulos

Freeman

Henry

et al. 2023

Circulation Research

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The onset and widespread dissemination of the severe acute respiratory syndrome coronavirus-2 in late 2019 impacted the world in a way not seen since the 1918 H1N1 pandemic, colloquially known as the Spanish Flu. Much like the Spanish Flu, which was observed to disproportionately impact young adults, it became clear in the early days of the coronavirus disease 2019 (COVID-19) pandemic that certain groups appeared to be at higher risk for severe illness once infected. One such group that immediately came to the forefront and garnered international attention was patients with preexisting cardiovascular disease. Here, we examine the available literature describing the interaction of COVID-19 with a myriad of cardiovascular conditions and diseases, paying particular attention to patients diagnosed with arrythmias, heart failure, and coronary artery disease. We further discuss the association of acute COVID-19 with de novo cardiovascular disease, including myocardial infarction due to coronary thrombosis, myocarditis, and new onset arrhythmias. We will evaluate various biochemical theories to explain these findings, including possible mechanisms of direct myocardial injury caused by the severe acute respiratory syndrome coronavirus-2 virus at the cellular level. Finally, we will discuss the strategies employed by numerous groups and governing bodies within the cardiovascular disease community to address the unprecedented challenges posed to the care of our most vulnerable patients, including heart transplant recipients, end-stage heart failure patients, and patients suffering from acute coronary syndromes, during the early days and height of the COVID-19 pandemic.

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Section: Acute Coronary Syndromes and Cardiac Catheterization Laborat...supporting

confidence: 75%

Interaction of COVID-19 With Common Cardiovascular Disorders

Boulos

Freeman

Henry

et al. 2023

Circulation Research

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“…In fact, SARS-Cov-2 positivity was associated with impaired epicardial reperfusion. 13 All these factors contributed to explain the higher inhospital mortality observed in SARS-Cov-2 positive patients as well as the higher rates of in-hospital definite in-stent thrombosis. These results were confirmed after adjustment for all baseline and procedural confounding factors.…”

Section: Discussionmentioning

confidence: 99%

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

Luca¹,

Algowhary

Uğuz

et al. 2022

Angiology

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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.

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“…Observational studies have shown that most of the time delay in STB is represented by the time interval between symptom onset and hospital arrival, with factors such as advanced age, diabetes, and initial admission to a non-PCI centre identified as the main predictors of prolonged STB time [44]. Interestingly, the SARS-CoV-2 pandemic demonstrated the impact of treatment delay on STEMI outcomes in the present era [45].…”

Section: Ischaemic Time: Can We Make It Shorter?mentioning

confidence: 99%

Treatment and Care of Patients with ST-Segment Elevation Myocardial Infarction—What Challenges Remain after Three Decades of Primary Percutaneous Coronary Intervention?

Zuccarelli,

Andreaggi,

Walsh

et al. 2024

JCM

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Primary percutaneous coronary intervention (pPCI) has revolutionized the prognosis of ST-segment elevation myocardial infarction (STEMI) and is the gold standard treatment. As a result of its success, the number of pPCI centres has expanded worldwide. Despite decades of advancements, clinical outcomes in STEMI patients have plateaued. Out-of-hospital cardiac arrest and cardiogenic shock remain a major cause of high in-hospital mortality, whilst the growing burden of heart failure in long-term STEMI survivors presents a growing problem. Many elements aiming to optimize STEMI treatment are still subject to debate or lack sufficient evidence. This review provides an overview of the most contentious current issues in pPCI in STEMI patients, with an emphasis on unresolved questions and persistent challenges.

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Angiographic and clinical outcome of SARS-CoV-2 positive patients with ST-segment elevation myocardial infarction undergoing primary angioplasty: A collaborative, individual patient data meta-analysis of six registry-based studies

Cited by 8 publications

References 39 publications

Interaction of COVID-19 With Common Cardiovascular Disorders

Interaction of COVID-19 With Common Cardiovascular Disorders

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

Treatment and Care of Patients with ST-Segment Elevation Myocardial Infarction—What Challenges Remain after Three Decades of Primary Percutaneous Coronary Intervention?

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