Subject: myocardial infarction
Subject: SARS-CoV-2
Subject: STEMI patients
Year: 2021
Type: Article
Title: Impact of SARS-CoV-2 positivity on clinical outcome among STEMI patients undergoing mechanical reperfusion: Insights from the ISACS STEMI COVID 19 registry
Author: De Luca, Giuseppe
Author: Debel, Niels
Author: Cercek, Miha
Author: Jensen, Lisette Okkels
Author: Vavlukis, Marija
Author: Calmac, Lucian
Author: Johnson, Tom
Author: Ferrer, Gerard Rourai
Author: Ganyukov, Vladimir
Author: Wojakowski, Wojtek
Author: Kinnaird, Tim
Author: von Birgelen, Clemens
Author: Cottin, Yves
Author: IJsselmuiden, Alexander
Author: Tuccillo, Bernardo
Author: Versaci, Francesco
Author: Royaards, Kees-Jan
Author: Berg, Jurrien ten
Author: Laine, Mika
Author: Dirksen, Maurits
Author: Siviglia, Massimo
Author: Casella, Gianni
Author: Kala, Petr
Author: Díez Gil, José Luis
Author: Banning, Adrian
Author: Becerra, Victor
Author: De Simone, Ciro
Author: Santucci, Andrea
Author: Carrillo, Xavier
Author: Scoccia, Alessandra
Author: Amoroso, Giovanni
Author: van't Hof, Arnoud WJ.
Author: Kovarnik, Tomas
Author: Tsigkas, Grigorios
Author: Mehilli, Julinda
Author: Gabrielli, Gabriele
Author: Rios, Xacobe Flores
Author: Bakraceski, Nikola
Author: Levesque, Sébastien
Author: Cirrincione, Giuseppe
Author: Guiducci, Vincenzo
Author: Kidawa, Michał
Author: Spedicato, Leonardo
Author: Marinucci, Lucia
Author: Ludman, Peter
Author: Zilio, Filippo
Author: Galasso, Gennaro
Author: Fabris, Enrico
Author: Menichelli, Maurizio
Author: Garcia-Touchard, Arturo
Author: Manzo, Stephane
Author: Caiazzo, Gianluca
Author: Moreu, Jose
Author: Forés, Juan Sanchis
Author: Donazzan, Luca
Author: Vignali, Luigi
Author: Teles, Rui
Author: Benit, Edouard
Author: Agostoni, Pierfrancesco
Author: Ojeda, Francisco Bosa
Author: Lehtola, Heidi
Author: Camacho-Freiere, Santiago
Author: Kraaijeveld, Adriaan
Author: Antti, Ylitalo
Author: Boccalatte, Marco
Author: Deharo, Pierre
Author: Martínez-Luengas, Iñigo Lozano
Author: Scheller, Bruno
Author: Varytimiadi, Efthymia
Author: Moreno, Raul
Author: Uccello, Giuseppe
Author: Faurie, Benjamin
Author: Gutierrez Barrios, Alejandro
Author: Milewski, Marek
Author: Bruwiere, Ewout
Author: Smits, Pieter
Author: Wilbert, Bor
Author: Di Uccio, Fortunato Scotto
Author: Parodi, Guido
Author: Kedhi, Elvin
Author: Verdoia, Monica
Abstract: Background and aims SARS-Cov-2 predisposes patients to thrombotic complications, due to excessive inflammation, endothelial dysfunction, platelet activation, and coagulation/fibrinolysis disturbances. The aim of the present study was to evaluate clinical characteristics and prognostic impact of SARS-CoV-2 positivity among STEMI patients undergoing primary percutaneous coronary intervention (PPCI). Methods We selected SARS-CoV-2 positive patients included in the ISACS-STEMI COVID-19, a retrospective multicenter European registry including 6609 STEMI patients treated with PPCI from March 1 until April 30, 2019 and 2020. As a reference group, we randomly sampled 5 SARS-Cov-2 negative patients per each SARS-CoV-2 positive patient, individually matched for age, sex, and hospital/geographic area. Study endpoints were in-hospital mortality, definite stent thrombosis, heart failure. Results Our population is represented by 62 positive SARS-CoV-2 positive patients who were compared with a matched population of 310 STEMI patients. No significant difference was observed in baseline characteristics or modality of access to the PCI center. In the SARS-CoV-2 positive patients, the culprit lesion was more often located in the RCA (p < 0.001). Despite similar pre and postprocedural TIMI flow, we observed a trend in higher use of GP IIb-IIIa inhibitors and significantly higher use of thrombectomy in the SARS-CoV-2 positive patients. SARS-CoV-2 positivity was associated with a remarkably higher in hospital mortality (29 % vs 5.5 %, p < 0.001), definite in-stent thrombosis (8.1 % vs 1.6 %, p = 0.004) and heart failure (22.6 % vs 10.6 %, p = 0.001) that was confirmed after adjustment for confounding factors. Conclusions Our study showed that among STEMI patients, SARS-CoV-2 positivity is associated with larger thrombus burden, a remarkably higher mortality but also higher rates of in-stent thrombosis and heart failure.
Publisher: Elsevier BV
Relation: Atherosclerosis
Identifier: oai:repository.ukim.mk:20.500.12188/14262
Identifier: http://hdl.handle.net/20.500.12188/14262Identifier: 10.1016/j.atherosclerosis.2021.06.926
Identifier: https://api.elsevier.com/content/article/PII:S0021915021012156?httpAccept=text/xmlIdentifier: https://api.elsevier.com/content/article/PII:S0021915021012156?httpAccept=text/plain
