The impact of COVID‐19 on clinical outcomes among acute myocardial infarction patients undergoing early invasive treatment strategy

Abstract

Background The implications of coronavirus disease 2019 (COVID‐19) infection on outcomes after invasive therapeutic strategies among patients presenting with acute myocardial infarction (AMI) are not well studied. Hypothesis To assess the outcomes of COVID‐19 patients presenting with AMI undergoing an early invasive treatment strategy. Methods This study was a cross‐sectional, retrospective analysis of the National COVID Cohort Collaborative database including all patients presenting with a recorded diagnosis of AMI (ST‐elevation myocardial infarction (MI) and non‐ST elevation MI). COVID‐19 positive patients with AMI were stratified into one of four groups: (1a) patients who had a coronary angiogram with percutaneous coronary intervention (PCI) within 3 days of their AMI; (1b) PCI within 3 days of AMI with coronary artery bypass graft (CABG) within 30 days; (2a) coronary angiogram without PCI and without CABG within 30 days; and (2b) coronary angiogram with CABG within 30 days. The main outcomes were respiratory failure, cardiogenic shock, prolonged length of stay, rehospitalization, and death. Results There were 10 506 COVID‐19 positive patients with a diagnosis of AMI. COVID‐19 positive patients with PCI had 8.2 times higher odds of respiratory failure than COVID‐19 negative patients ( p = .001). The odds of prolonged length of stay were 1.7 times higher in COVID‐19 patients who underwent PCI ( p = .024) and 1.9 times higher in patients who underwent coronary angiogram followed by CABG ( p = .001). Conclusion These data demonstrate that COVID‐19 positive patients with AMI undergoing early invasive coronary angiography had worse outcomes than COVID‐19 negative patients.

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

“…We included any original paper reporting the use of PCI for ACS patients infected with or without COVID-19. We excluded review papers, conference abstracts, papers that include only COVID-19 patients without a comparator to negative controls, papers that included ACS patients with a past history of COVID-19 without indicating the COVID-19 status before the procedure 17 , papers with sample size less than 10 and duplicated papers. Outcomes of interest were extracted from included papers in a pre-made excel form.…”

Familial Hypercholesterolemia Patients with COVID-19—Effective Cholesterol-Lowering Therapy is Urgent both during and after Infection

“…The respective incidence rate ratios for ischemic stroke were 2.97 (1.71–5.15) in the first week, 2.80 (1.60–4.88) in the second week, and 2.10 (1.33–3.32) in weeks 3 and 4 following COVID-19. Additionally, the American retrospective analysis of COVID-19 patients with a diagnosis of acute AMI registered in the National COVID Cohort Database revealed that COVID-19 patients with AMI undergoing early invasive coronary angiography had a worse prognosis compared to those without COVID-19 [ 2 ]. Impressively, in this study, nearly 80% of COVID-19 positive and negative groups with AMI had hypercholesterolemia.…”