Coronary interventions - Mini focus on STEMI

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

EuroIntervention 2021;16:1426-1433. DOI: 10.4244/EIJ-D-20-00935

Oriol Rodríguez-Leor
Oriol Rodriguez-Leor1,2,3, MD, PhD; Ana Belen Cid Alvarez4, MD; Armando Pérez de Prado5, MD, PhD; Xavier Rossello2,6,7, MD, PhD; Soledad Ojeda8, MD, PhD; Ana Serrador2,9, MD, PhD; Ramon López-Palop10, MD, PhD; Javier Martin-Moreiras2,11, MD, PhD; Jose Ramon Rumoroso12, MD, PhD; Angel Cequier13, MD, PhD; Borja Ibáñez2,6,14, MD, PhD; Ignatio Cruz-González2,11, MD, PhD; Rafael Romaguera13, MD, PhD; Raúl Moreno2,15, MD, PhD
1. Institut del Cor, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; 2. CIBER de Enfermedades CardioVasculares (CIBERCV) Instituto de Salud Carlos III, Madrid, Spain; 3. Institut de Recerca en Ciències de la Salut Germans Trias i Pujol, Badalona, Spain; 4. Cardiology Department, Hospital Clínico de Santiago de Compostela, Santiago de Compostela, Spain; 5. Cardiology Department, Hospital de León, León, Spain; 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

Aims: The aim of this study was 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 two different cohorts, according to whether or not they had COVID-19. Among 1,010 consecutive STEMI patients, 91 were identified as having COVID-19 (9.0%). With the exception of smoking status (more frequent in non-COVID-19 patients) and previous coronary artery disease (more frequent in COVID-19 patients), clinical characteristics were similar between the 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 GP IIb/IIIa inhibitor 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 ischaemic time (OR 4.85, 95% CI: 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 mortality, stent thrombosis and cardiogenic shock development after PCI in patients with STEMI and COVID-19 in comparison with contemporaneous non-COVID-19 STEMI patients.

Visual summary. In-hospital outcomes of COVID-19 ST-elevation myocardial infarction patients.

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Coronary interventionsSTEMIOther coronary interventions
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