Characteristics and Outcomes in Patients Presenting With COVID-19 and ST-Segment Elevation Myocardial Infarction (original) (raw)
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The Outcome of COVID-19 Patients with Acute Myocardial Infarction
Background Coronavirus Disease 2019 (COVID-19) is a rapidly expanding global pandemic resulting in significant morbidity and mortality. COVID-19 patients may present with acute myocardial infarction (AMI). The aim of this study is to conduct detailed analysis on patients with AMI and COVID-19. Methods We included all patients admitted with AMI and actively known or found to be COVID-19 positive by PCR between the 4th February 2020 and the 11th June 2020 in the State of Qatar. Patients were divided into ST-elevation myocardial infarction (STEMI) and Non-STE (NSTEMI). Results There were 68 patients (67 men and 1 woman) admitted between the 4th of February 2020 and the 11th of June 2020 with AMI and COVID-19. The mean age was 49.1, 46 patients had STEMI and 22 had NSTEMI. 38% had diabetes mellitus, 31% had hypertension, 16% were smokers, 13% had dyslipidemia, and 14.7% had prior cardiovascular disease. Chest pain and dyspnea were the presenting symptoms in 90% and 12% of patients respe...
International Journal of Cardiology
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ST Elevation Myocardial Infarction in Patients with COVID-19: Case Series
European Medical Journal, 2022
Severe acute respiratory syndrome coronavirus 2, or COVID-19, has triggered an unprecedented pandemic situation across the globe. Patients with COVID-19 frequently experience a range of clinical complications driven by their health status, comorbidities, and disease responsiveness. Patients with COVID-19 also encounter cardiovascular conditions that potentially increase their risk for mortality. Few clinical studies reveal the development of ST segment elevation myocardial infarction (STEMI) in patients with COVID-19. New York City, USA, continues to witness and report a high incidence and prevalence of COVID-19 infections. New York City's healthcare centres and hospitals have treated more than 6,000 cases of COVID-19 pneumonia in their inpatient and intensive care units. The authors conducted a retrospective study of patients admitted to NYC Health + Hospitals, Queens, New York City, USA, with confirmed COVID-19 reverse transcriptase-PCR test findings between 29 th March 2020 and 1 st May 2020. The authors used a retrospective case series design to evaluate the association between laboratory-confirmed COVID-19 infection and hospitalisation for acute myocardial infarction. They utilised a series of ECGs to record and analyse STEMI patterns across patients with COVID-19. This study aimed to determine the risk/incidence of STEMI in patients with COVID-19, and its impact on their clinical presentation, angiographic findings, and clinical outcomes. The authors hypothesised STEMI as a significant COVID-19 complication, with the potential to impact the long-term prognostic outcomes of patients with COVID-19.
European Journal of Clinical Investigation
To compare major cardiovascular and cerebrovascular events (MACCE) rates between patients in the pre-COVID-19 era and COVID-19 era, and to assess the impact of the presence of COVID-19 (+) on long-term MACCE in ST-segment elevation myocardial infarctio n (STEMI) in Turkey. Methods: Using the TURSER study (TURKISH ST-segment elevation myocardial infarct io n registry) data, the current study included 1748 STEMI patients from 15 centers in Turkey. Patients were stratified into COVID-19 era (March 11st-May 15st, 2020; n = 723) or pre-COVID-19 era (March 11st-May 15st, 2019; n = 1025) cohorts. Long-term MACCE rates were compared between groups. In addition, the effect of COVID-19 positivity on long-term outcomes was evaluated. The primary outcome was the occurrence of MACCE at long-term follow-up, and the secondary outcome was hospitalization with heart failure. Results: The MACCE and hospitalization with heart failure rates between pre-COVID-19 era and COVID-19 era were 23% vs 22% (p = 0.841), and 12% vs %8 (p = 0.002), respectively. In the covid-19 era, the rates of MACCE and hospitalization with heart failure COVID-19 positive versus COVID-19 negative patients were 40% vs 20%, (p < 0.001), and 43% vs 11% (p < 0.001), respectively. Conclusion: There was no difference between the pre-COVID-19 era and the COVID-19 era in terms of MACCE and heart failure hospitalization in STEMI patients in Turkey. In the Covid-19 era, STEMI patients positive for COVID-19 had a higher rate of MACCE and heart failure hospitalization at the long-term follow-up.
The Challenges of ST-Elevation Myocardial Infarction in COVID-19 Patients
Case Reports in Cardiology
By July 2021, the United States had over 34.4 million confirmed COVID-19 cases. Various cardiovascular manifestations of COVID-19 have been reported including ST-elevation myocardial infarction (STEMI), and there is concern that SARS-CoV-2 may be associated with a higher thrombus burden. We performed a retrospective chart review of 535 adult patients with COVID-19 admitted at Yale-New Haven Health Greenwich Hospital from February 1, 2020, to May 13, 2020. All admitted patients had undergone testing for serum troponin I and various inflammatory markers, and we identified three patients who were diagnosed with acute STEMI. Data was collected via manual chart review and included patient demographics, comorbidities, laboratory tests, electrocardiogram (ECG) results, echocardiography results, diagnoses during hospitalization, inpatient therapies, and outcomes including length of hospital stay, revascularization results, and mortality. Three of our patients had obstructive coronary artery...
Journal of Clinical Medicine
Primary percutaneous coronary intervention (PPCI) is one of the important clinical procedures that have been affected by the COVID-19 pandemic. In this study, we aimed to assess the incidence and impact of COVID-19 on in-hospital clinical outcome of ST elevation myocardial infarction (STEMI) patients managed with PPCI. This observational retrospective study was conducted on consecutive STEMI patients who presented to the International Cardiac Center (ICC) hospital, Alexandria, Egypt between 1 February and 31 October 2020. A group of STEMI patients presented during the same period in 2019 was also assessed (control group) and data was used for comparison. The inclusion criteria were established diagnosis of STEMI requiring PPCI.A total of 634 patients were included in the study. During the COVID-19 period, the number of PPCI procedures was reduced by 25.7% compared with previous year (mean 30.0 ± 4.01 vs. 40.4 ± 5.3 case/month) and the time from first medical contact to Needle (FMC-t...
PLOS ONE, 2021
BackgroundWe aimed to describe the characteristics and in-hospital outcomes of ST-segment elevation myocardial infarction (STEMI) patients during the Covid-19 era.MethodsWe conducted a prospective, multicenter study involving 13 intensive cardiac care units, to evaluate consecutive STEMI patients admitted throughout an 8-week period during the Covid-19 outbreak. These patients were compared with consecutive STEMI patients admitted during the corresponding period in 2018 who had been prospectively documented in the Israeli bi-annual National Acute Coronary Syndrome Survey. The primary end-point was defined as a composite of malignant arrhythmia, congestive heart failure, and/or in-hospital mortality. Secondary outcomes included individual components of primary outcome, cardiogenic shock, mechanical complications, electrical complications, re-infarction, stroke, and pericarditis.ResultsThe study cohort comprised 1466 consecutive acute MI patients, of whom 774 (53%) were hospitalized d...
European Journal of Clinical Investigation, 2022
AimsTo compare major cardiovascular and cerebrovascular events (MACCE ) rates between patients in the pre‐COVID‐19 era and COVID‐19 era, and to assess the impact of the presence of COVID‐19 (+) on long‐term MACCE in ST‐segment elevation myocardial infarction (STEMI) in Turkey.MethodsUsing the TURSER study (TURKISH ST‐segment elevation myocardial infarction registry) data, the current study included 1748 STEMI patients from 15 centers in Turkey. Patients were stratified into COVID‐19 era (March 11st–May 15st, 2020; n = 723) or pre‐ COVID‐19 era (March 11st–May 15st, 2019; n = 1025) cohorts. Long‐term MACCE rates were compared between groups. In addition, the effect of COVID‐19 positivity on long‐term outcomes was evaluated. The primary outcome was the occurrence of MACCE at long‐term follow‐up, and the secondary outcome was hospitalization with heart failure.ResultsThe MACCE and hospitalization with heart failure rates between pre‐COVID‐19 era and COVID‐19 era were 23% vs 22% (p = 0.841), and 12% vs %8 (p = 0.002), respectively. In the covid‐19 era, the rates of MACCE and hospitalization with heart failure COVID‐19 positive versus COVID‐19 negative patients were 40% vs 20%, (p < 0.001), and 43% vs 11% (p < 0.001), respectively.ConclusionThere was no difference between the pre‐COVID‐19 era and the COVID‐19 era in terms of MACCE and heart failure hospitalization in STEMI patients in Turkey. In the Covid‐19 era, STEMI patients positive for COVID‐19 had a higher rate of MACCE and heart failure hospitalization at the long‐term follow‐up.
In-hospital outcomes of COVID-19 ST-elevation myocardial infarction patients
EuroIntervention, 2021
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.