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- Title
SARS-CoV-2 Positivity, Stent Thrombosis, and 30-day Mortality in STEMI Patients Undergoing Mechanical Reperfusion.
- Authors
De Luca, Giuseppe; Algowhary, Magdy; Uguz, Berat; Oliveira, Dinaldo C; Ganyukov, Vladimir; Zimbakov, Zan; Cercek, Miha; Okkels Jensen, Lisette; Loh, Poay Huan; Calmac, Lucian; Roura i Ferrer, Gerard; Quadros, Alexandre; Milewski, Marek; Scotto Di Uccio, Fortunato; von Birgelen, Clemens; Versaci, Francesco; Ten Berg, Jurrien; Casella, Gianni; Wong Sung Lung, Aaron; Kala, Petr
- Abstract
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.
- Subjects
THROMBOSIS complications; COVID-19; PERCUTANEOUS coronary intervention; CONFIDENCE intervals; SURGICAL stents; ACUTE coronary syndrome; HYPERCHOLESTEREMIA; ST elevation myocardial infarction; TREATMENT effectiveness; HOSPITAL mortality; COMPARATIVE studies; HOSPITAL care; CARDIOGENIC shock; REPERFUSION; ODDS ratio; SMOKING; EVALUATION
- Publication
Angiology, 2023, Vol 74, Issue 10, p987
- ISSN
0003-3197
- Publication type
Article
- DOI
10.1177/00033197221129351