ST-segment elevation in patients with COVID-19: a systematic review.
Carlos Diaz-ArocutipaJavier Torres-ValenciaJose Saucedo-ChinchayCecilia CuevasPublished in: Journal of thrombosis and thrombolysis (2021)
Coronavirus disease 2019 (COVID-19) can cause a wide range of cardiovascular diseases, including ST-segment elevation myocardial infarction (STEMI) and STEMI-mimickers (such as myocarditis, Takotsubo cardiomyopathy, among others). We performed a systematic review to summarize the clinical features, management, and outcomes of patients with COVID-19 who had ST-segment elevation. We searched electronic databases from inception to September 30, 2020 for studies that reported clinical data about COVID-19 patients with ST-segment elevation. Differences between patients with and without obstructive coronary artery disease (CAD) on coronary angiography were evaluated. Forty-two studies (35 case reports and seven case series) involving 161 patients were included. The mean age was 62.7 ± 13.6 years and 75% were men. The most frequent symptom was chest pain (78%). Eighty-three percent of patients had obstructive CAD. Patients with non-obstructive CAD had more diffuse ST-segment elevation (13% versus 1%, p = 0.03) and diffuse left ventricular wall-motion abnormality (23% versus 3%, p = 0.02) compared to obstructive CAD. In patients with previous coronary stent (n = 17), the 76% presented with stent thrombosis. In the majority of cases, the main reperfusion strategy was primary percutaneous coronary intervention instead of fibrinolysis. The in-hospital mortality was 30% without difference between patients with (30%) or without (31%) obstructive CAD. Our data suggest that a relatively high proportion of COVID-19 patients with ST-segment elevation had non-obstructive CAD. The prognosis was poor across groups. However, our findings are based on case reports and case series that should be confirmed in future studies.
Keyphrases
- coronary artery disease
- percutaneous coronary intervention
- st segment elevation myocardial infarction
- coronavirus disease
- acute myocardial infarction
- st elevation myocardial infarction
- coronary artery bypass grafting
- antiplatelet therapy
- cardiovascular events
- sars cov
- ejection fraction
- newly diagnosed
- end stage renal disease
- aortic stenosis
- left ventricular
- heart failure
- acute coronary syndrome
- prognostic factors
- electronic health record
- case report
- low grade
- coronary artery
- respiratory syndrome coronavirus
- type diabetes
- chronic kidney disease
- coronary artery bypass
- insulin resistance
- hypertrophic cardiomyopathy
- pulmonary embolism
- big data
- middle aged
- case control
- patient reported
- current status
- metabolic syndrome