Comparison of Angiographic and Clinical Outcomes After Primary Percutaneous Coronary Intervention for ST-elevation Myocardial Infarction Between Patients With and Without Concomitant COVID-19 Infection

Abstract

Objective: COVID-19 infection can involve the cardiovascular system and worsen the prognosis of the patients. This study aimed to investigate the adverse effects of COVID-19 on angiographic and clinical outcomes of primary percutaneous coronary intervention (PCI) in patients with acute ST-elevation MI and compare results with those patients without COVID-19 disease. Methods: The study was a retrospective observational cohort, in which patients presented with ST-elevation MI from February 2020 to April 2021, treated with primary PCI were divided into 2 groups based on the COVID-19 infection. Then, the procedural and angiographic indices and also clinical outcomes were compared between the 2 groups. Results: A total of 1150 patients were enrolled in the study. Those with established COVID-19 infection had worse baseline thrombolysis in myocardial infarction flow grade and also were at higher risk for worse procedural outcomes such as lower thrombolysis in myocardial infarction frame count, myocardial blush grade, and slow-flow coronary disease, after the primary PCI. Additionally, the presence of COVID-19 at the time of primary PCI was related to a significantly higher duration of hospitalization and in-hospital mortality. Given the potential impact of other factors on outcomes, analysis for all of the primary endpoints was done again after adjustment of these factors and the results were the same as before, suggesting the independent effect of COVID-19 infection. Conclusions: The concomitant COVID-19 infection in the patients undergoing primary PCI is associated with significantly worse angiographic, procedural and clinical outcomes. Surprisingly, this finding is regardless of patients’ baseline risk factors and demographical characteristics.

The effect of COVID-19 on the in-hospital outcomes of percutaneous coronary intervention in patients with acute coronary syndrome: A large scale meta-analysis

“…Title and abstract screening of 1075 records based upon our inclusion and exclusion criteria resulted in 92 full texts for further screening. We included 4 papers together with another 2 papers from manual search, in addition to another 5 papers from the search update 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 ( Figure 1 ).…”

Histologic Assessment of Thromboemboli Due to Plaque Rupture, Plaque Erosion, or COVID-19 Microthrombi

“… 4 According to an angiographic study, patients with COVID-19 infection had worse thrombolysis in myocardial infarction flow grade at baseline and after PCI. 10 As shown in Figure 5 , case 3 had multiple microthrombi in intramyocardial microvessels, which is likely one of the main causes of elevated cardiac troponin in the setting of COVID-19 infection and portends a poor prognosis. Furthermore, as shown in Figure 5E , microthrombi IHC in case 3 showed that they were strongly positive for CD61, fibrin II, D-dimer, and C5b-9.…”

The Impact of the COVID-19 Pandemic on Hospitalization Rates due to Prosthetic Valve Thrombosis

“…Due to the high risk of staff contamination, TEE should be avoided as much as possible and be limited to occasions when there are crucially suspicious findings or when it might change the treatment approach. 22 The decline in hospitalization length has been a worldwide issue since the start of the pandemic, 14 , 16 , 17 , 23 representing physicians’ and patients’ inclination toward an early discharge, as well as hospitals’ endeavors to ensure bed availability.…”