Specific characteristics of STEMI in COVID-19 patients  and their practical implications

Gitto, Mauro; Novelli, Laura; Reimers, Bernhard; Condorelli, Gianluigi; Stefanini, Giulio

doi:10.33963/kp.a2022.0072

Cited by 12 publications

(15 citation statements)

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“…Despite a comparable delay, COVID-19 patients had significantly higher mortality rates in our study, 48% vs. 10%, which is in the wide range observed around the world when compared to the pre-COVID-19 era. (15.4–79.9%) [ 12 ]. This allowed us to exclude delay as a cause of increased mortality in this group.…”

Section: Discussionmentioning

confidence: 99%

“…Kaziród-Wolski et al found no significant association between periprocedural death during acute coronary syndromes (ACS) and vaccinations against COVID-19 in 6 weeks of observations; however, their protective role observed in a long-term perspective as in the case of vaccinations against influenza remains unknown [ 11 ]. Despite the existence of various tools for primary prevention and treatment, COVID-19 still represent a major worldwide problem and its long-term impact on health remains unclear [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

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High in-hospital mortality and prevalence of cardiogenic shock in patients with ST-segment elevation myocardial infarction and concomitant COVID-19

Wójcik¹,

Karpiak²,

Zaręba³

et al. 2023

pwki

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Introduction: Published data suggest worse outcomes in acute coronary syndrome (ACS) patients with concomitant coronavirus disease (COVID-19) due to delays in standard management caused by burdened healthcare.Aim: To report the demographics, angiographic findings, and in-hospital outcomes of COVID-19 ST-elevation myocardial infarction (STEMI) patients and to compare these with the non-COVID-19 cohort hospitalized during the same period with the same access to medical care.Material and methods: From October 23 rd , 2020 to April 23 rd , 2021 (exactly 6 months) data were collected into a prospective ACS Registry. STEMI patients underwent invasive coronary angiography and were tested for COVID-19. Outcomes were in-hospital mortality and prevalence of cardiogenic shock.Results: 125 patients, of whom 25 were COVID-19 positive, were admitted to the cardiology ward, and completed their hospital stay (i.e. discharge or death). There were no differences with regard to the time from symptom onset to reperfusion (median (Q1-Q3); 165 (130-202) vs. 170 (123-210), p = 0.86) and door-to-balloon time between the compared groups (25 (21-35) vs. 29 (21-59), p = 0.26). There was a higher GRACE risk score and mortality in the COVID-19 positive patients (180 (154-226) vs. 155 (132-181) and 48% vs. 10%, respectively, both p < 0.0001). Cardiogenic shock occurred more often in this group (32% vs. 13%; p = 0.035). COVID-19 positive patients had elevated high-sensitivity C-reactive protein (hsCRP) (p < 0.0001) and D-dimer (p = 0.003) and reduced left ventricular ejection fraction (p = 0.037). Postprocedural TIMI 3 flow grade was observed less frequently in this group (p = 0.044).Conclusions: High in-hospital mortality in patients with STEMI and COVID-19 did not result from delays in standard management, and could be related to increased thrombogenicity.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

High in-hospital mortality and prevalence of cardiogenic shock in patients with ST-segment elevation myocardial infarction and concomitant COVID-19

Wójcik¹,

Karpiak²,

Zaręba³

et al. 2023

pwki

View full text Add to dashboard Cite

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“…Baseline characteristics and past medical drug history were statistically similar between the groups, however, the prevalence of diabetes mellitus and CKD was higher among patients with COVID-19 disease, and these patients were older than subjects without COVID-19 (62.9 vs. 59.9 years old, respectively, P = 0.01). Some studies reported a higher prevalence of diabetes and CKD in patients with COVID-19 infection and STEMI, 22 suggesting that these factors not only increase the risk of COVID-19 infection but also can increase the incidence of STEMI in these patients by causing endothelial dysfunction and affecting the immune system. 23 The main findings in this study are that COVID-19 positive patients have higher risk angiographic characteristics, including lower baseline TIMI flow grade, multivessel thrombosis, and trend toward higher thrombotic burden, which was associated with more administration of glycoprotein IIb/IIIa inhibitors during the procedure.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

Mohsenizadeh

Alidoosti

Jalali

et al. 2022

Critical Pathways in Cardiology: A Journal of Evidence-Based Medicine

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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.

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“…Течение COVID-19 может сопровождаться не только обострением хронических сердечно-сосудистых заболеваний, но и, в ряде случаев, может стать причиной развития инфаркта миокарда (ИМ) [2]. В литературе приводятся данные о высоком риске развития острого коронарного синдрома (ОКС) у пациентов с сопутствующей сердечно-сосудистой патологией, инфицированных COVID-19 [3]. При этом течение ОКС сопряжено с более неблагоприятными исходами.…”

Section: ключевые моменты Key Messagesunclassified

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

Chashchin

Strelkova²,

Gorshkov³

et al. 2023

Russ J Cardiol

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Aim. To study clinical and anamnestic data, as well as inhospital outcomes in patients with ST elevation myocardial infarction (STEMI) with prior coronavirus disease 2019 (COVID-19) compared with previously uninfected STEMI patients.Material and methods. This prospective study included 181 patients treated for STEMI. The patients were divided into 2 groups, depending on the anti-SARS-CoV-2 IgG titer as follows: the main group included 62 seropositive patients, while the control group — 119 seronegative patients without prior COVID-19. Anamnesis, clinical and paraclinical examination, including electrocardiography, echocardiography, coronary angiography, were performed. Mortality and incidence of STEMI complications at the hospital stage were analyzed.Results. The mean age of the patients was 62,6±12,3 years. The vast majority were men (69,1% (n=125)). The median time from the onset of COVID-19 manifestations to STEMI was 60,00 [45,00; 83,00] days. According to, the patients of both groups were comparable the severity of circulatory failure (p>0,05). Coronary angiography found that in patients of the main group, Thrombolysis In Myocardial Infarction (TIMI) score of 0-1 in the infarct-related artery was recorded much less frequently (62,9% (n=39) vs, 77,3% (n=92), p=0,0397). Patients of the main group demonstrated a lower concentration of leukocytes (9,30*109/l [7,80; 11,40] vs 10,70*109/l [8,40; 14,00], p=0,0065), higher levels of C-reactive protein (21,5 mg/L [9,1; 55,8] vs 10,2 mg/L [5,1; 20,5], p=0,0002) and troponin I (9,6 ng/mL [2,2; 26,0] vs 7,6 ng/mL [2,2; 11,5], p=0,0486). Lethal outcome was recorded in 6,5% (n=4) of cases in the main group and 8,4% (n=10) in the control group (p=0,6409). Both groups were comparable in terms of the incidence of complications (recurrent myocardial infarction, ventricular fibrillation, complete atrioventricular block, stroke, gastrointestinal bleeding) during hospitalization (p>0,05).Conclusion. Patients with STEMI after COVID-19, despite a more burdened history and higher levels of C-reactive protein and troponin I, compared with STEMI patients without COVID-19, did not differ significantly in clinical status, morbidity, and inhospital mortality.

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Specific characteristics of STEMI in COVID-19 patients and their practical implications

Cited by 12 publications

References 0 publications

High in-hospital mortality and prevalence of cardiogenic shock in patients with ST-segment elevation myocardial infarction and concomitant COVID-19

High in-hospital mortality and prevalence of cardiogenic shock in patients with ST-segment elevation myocardial infarction and concomitant COVID-19

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

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

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