SARS-CoV-2 Positivity, Stent Thrombosis, and 30-day Mortality in STEMI Patients Undergoing Mechanical Reperfusion.
Giuseppe De LucaMagdy AlgowharyBerat UguzDinaldo C OliveiraVladimir GanyukovZan ZimbakovMiha CercekLisette Okkels JensenPoay Huan LohLucian CalmacGerard Roura I FerrerAlexandre QuadrosMarek MilewskiFortunato Scotto Di UccioClemens von BirgelenFrancesco VersaciJurrien Ten BergGianni CasellaAaron Wong Sung LungPetr KalaJosé Luis Díez GilXavier CarrilloMaurits DirksenVictor M Becerra-MunozMichael Kang-Yin LeeDafsah Arifa JuzarRodrigo de Moura JoaquimCiro De SimoneDavor MilicicPeriklis DavlourosNikola BakraceskiFilippo ZilioLuca DonazzanAdriaan KraaijeveldGennaro GalassoLux ArpadLucia MarinucciVincenzo GuiducciMaurizio MenichelliAlessandra ScocciaAylin Hatice YamacKadir Ugur MertXacobe Flores RiosTomas KovarnikMichal KidawaJosè MoreuVincent FlavienEnrico FabrisIñigo Lozano Martínez-LuengasMarco BoccalatteFrancisco Bosa OjedaCarlos Arellano-SerranoGianluca CaiazzoGiuseppe CirrincioneHsien-Li KaoJuan Sanchis ForésLuigi VignaliHelder PereiraStephane Manzo-SilbermannSantiago OrdoñezAlev Arat ÖzkanBruno SchellerHeidi LehtolaRui TelesChristos MantisYlitalo AnttiJoão António Brum SilveiraIvan BessonovRodrigo ZoniStefano SavonittoGeorge KochiadakisDimitrios AlexopoulosCarlos E UribeJohn KanakakisBenjamin FaurieGabriele GabrielliAlejandro Gutierrez BarriosJuan Pablo BachiniAlex RochaFrankie Chor-Cheung TamAlfredo RodriguezAntonia Anna LukitoAnne Bellemain-AppaixGustavo PessahGiuliana CorteseGuido ParodiMohammed Abed BurgadhaElvin KedhiPablo LamelasHarry SuryapranataMatteo NardinMonica VerdoiaPublished in: Angiology (2022)
SARS-Cov-2 has been suggested to promote thrombotic complications and higher mortality. The aim of the present study was to evaluate the impact of SARS-CoV-2 positivity on in-hospital outcome and 30-day mortality in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI) enrolled in the International Survey on Acute Coronary Syndromes ST-segment elevation Myocardial Infarction (ISACS-STEMI COVID-19 registry. The 109 SARS-CoV-2 positive patients were compared with 2005 SARS-CoV-2 negative patients. Positive patients were older ( P = .002), less often active smokers ( P = .002), and hypercholesterolemic ( P = .006), they presented more often later than 12 h ( P = .037), more often to the hub and were more often in cardiogenic shock ( P = .02), or requiring rescue percutaneous coronary intervention after failed thrombolysis (P < .0001). Lower postprocedural Thrombolysis in Myocardial Infarction 3 flow ( P = .029) and more thrombectomy ( P = .046) were observed. SARS-CoV-2 was associated with a significantly higher in-hospital mortality (25.7 vs 7%, adjusted Odds Ratio (OR) [95% Confidence Interval] = 3.2 [1.71-5.99], P < .001) in-hospital definite in-stent thrombosis (6.4 vs 1.1%, adjusted Odds Ratio [95% CI] = 6.26 [2.41-16.25], P < .001) and 30-day mortality (34.4 vs 8.5%, adjusted Hazard Ratio [95% CI] = 2.16 [1.45-3.23], P < .001), confirming that SARS-CoV-2 positivity is associated with impaired reperfusion, with negative prognostic consequences.
Keyphrases
- sars cov
- percutaneous coronary intervention
- st segment elevation myocardial infarction
- acute myocardial infarction
- acute coronary syndrome
- st elevation myocardial infarction
- respiratory syndrome coronavirus
- coronary artery disease
- antiplatelet therapy
- end stage renal disease
- patients undergoing
- coronary artery bypass grafting
- chronic kidney disease
- cardiovascular events
- newly diagnosed
- ejection fraction
- pulmonary embolism
- prognostic factors
- healthcare
- risk factors
- cardiovascular disease
- patient reported outcomes
- coronavirus disease
- drug induced
- network analysis