Outcomes of Primary Percutaneous Coronary Intervention in Post COVID-19 Patients presenting with ST Segment Elevation Myocardial Infarction

Abstract

Background: COVID-19 can cause a wide range of thrombotic diseases, including acute coronary syndromes (ACS). While these thrombotic diseases occur during acute infection, evidence on the long-term thrombotic consequences of COVID-19 remain unknown. Objective: The aim of the current study was to establish the particular coronary angiographic findings, as well as the procedural and clinical effectiveness of revascularization in post COVID-19 patients presenting with STEMI. Patients and methods: A total 100 patients presented to Ain Shams University Hospitals with ST Segment Elevation Myocardial Infarction (STEMI) managed by primary percutaneous coronary intervention (PCI). Participants were divided into two groups: Group (A) included 50 patients who developed COVID-19 infection in the previous 6 months, and Group (B) included 50 patients who deny COVID-19 infection in the previous 6 months. Group (A) was divided into two subgroups: the Early Post-COVID subgroup, which included 16 patients who developed STEMI within 8 weeks of infection, and the Late Post-COVID subgroup, which included 34 patients who developed STEMI >8-24 weeks after infection. Results: The Early Post-COVID subgroup had a statistically significant high thrombus load on angiography, with 81.3% versus 48% in the control group. This resulted in a statistically significant increase in the utilization of predilatation (56.2% versus 24%) and thrombus aspiration (43.8% versus 4%) in the Early Post-COVID grouping (Pvalues 0.015 and 0.001, respectively). Coronary no-reflow was a substantially more common in the Early post-COVID subgroup (62.5%) than in the control group (22%). This translated into a higher Major Adverse Cardiovascular Events (MACE) among Early Post-COVID patients, at 31.3% versus 6% in the control group. Conclusion:The thrombogenic impact of COVID-19 on STEMI outcomes continues even after infection clearance being greatest during the first 8 weeks following infection and thereafter diminishes. It has an impact on the angiographic, procedural, and overall clinical success of in-hospital revascularization.