The Official Journal of EuroPCR and the European Association of Percutaneous Coronary Interventions (EAPCI)

In-hospital outcomes of patients with ST-segment elevation myocardial infarction and COVID-19

DOI: 10.4244/EIJ-D-20-00935

1. Institute del Cor, Hospital Universitario Germas Trias i Pujol, Badalona, Spain.
2. CIBER de Enfermedades Cardiovasculares (CIBERCV) Instituto de Salud Carols III, Madrid, Spain.
3. Institut de Recerca en Ciències de la Salut Germans Trias i Pujol, Badalona, Spain, Spain
4. Cardiology Department, Hospital Clínico de Santiago de Compostela, Santiago de Compostela, Spain
5. Cardiology Department, Hospital de León, León, España
6. Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), Madrid, Spain.
7.Cardiology Department, Health Research Institute of the Balearic Islands (IdISBa), Hospital Universitari Son Espases, Palma, Spain. 
8. Cardiology Department, Hospital Universitario Reina Sofía, IMIBIC, Universidad de Córdoba, Córdoba, Spain
9. Cardiology Department, Hospital Clínico de Valladolid, Valladolid, Spain. 
10. Cardiology Department, Hospital Virgen de la Arrixaca, El Palmar, Murcia, Spain
11. Cardiology Department, Hospital Universitario de Salamanca, IBSAL, Salamanca, Spain. 
12. Cardiology Department, Hospital de Galdakao-Usansolo, Galdakao, Vizcaya, Spain
13. Cardiology Department, Hospital de Bellvitge - IDIBELL, Universitat de Barcelona, L’Hospitalet de Llobregat, Barcelona, Spain
14. Cardiology Department, IIS-Fundación Jiménez Díaz University Hospital, Madrid, Spain. 
15. Cardiology Department, Hospital de La Paz, Madrid, Spain. 
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Aims

To assess clinical and prognosis differences in patients with Covid-19 and STEMI.

Methods and results

Using a nationwide registry of consecutive patients managed within 42 specific STEMI-care networks, we compared patient and procedure characteristics and in-hospital outcomes in 2 different cohorts, according to whether they had Covid-19.

Among 1010 consecutive STEMI patients, 91 were identified as Covid-19 (10.9%).

With the exception of smoking status (more frequent in non-Covid-19) and previous coronary artery disease (more frequent in Covid-19), clinical characteristics were similar between groups, but Covid-19 patients had more heart failure on arrival (31.9% vs 18.4%, p=0.002). Mechanical thrombectomy (44% vs 33.5%, p=0.046) and IIbIIIa inhibitors administration (20.9% vs 11.2%, p=0.007) were more frequent in Covid-19 patients, who had an increased in-hospital mortality (23.1% vs 5.7%, p<0.0001), that remained consistent after adjustment for age, sex, Killip class and ischemic time: OR (95% CI) = 4.85 (2.04-11.51); p<0.001. Covid-19 patients had an increase of stent thrombosis (3.3% vs 0.8%, p=0.020) and cardiogenic shock development after PCI (9.9 % vs 3.8%, p=0.007).

Conclusions

Our study revealed a significant increase in in-hospital, stent thrombosis and cardiogenic shock development after PCI in patients with STEMI and Covid-19 in comparison with contemporaneous non-Covid-19 STEMI patients.

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