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.
SARS-CoV-2 Positivity, Stent Thrombosis, and 30-day Mortality in STEMI Patients Undergoing Mechanical Reperfusion / De Luca, G.; Algowhary, M.; Uguz, B.; Oliveira, D. C.; Ganyukov, V.; Zimbakov, Z.; Cercek, M.; Okkels Jensen, L.; Loh, P. H.; Calmac, L.; Roura i Ferrer, G.; Quadros, A.; Milewski, M.; Scotto Di Uccio, F.; von Birgelen, C.; Versaci, F.; Ten Berg, J.; Casella, G.; Wong Sung Lung, A.; Kala, P.; Diez Gil, J. L.; Carrillo, X.; Dirksen, M.; Becerra-Munoz, V. M.; Kang-yin Lee, M.; Juzar, D. A.; de Moura Joaquim, R.; De Simone, C.; Milicic, D.; Davlouros, P.; Bakraceski, N.; Zilio, F.; Donazzan, L.; Kraaijeveld, A.; Galasso, G.; Arpad, L.; Marinucci, L.; Guiducci, V.; Menichelli, M.; Scoccia, A.; Yamac, A. H.; Ugur Mert, K.; Flores Rios, X.; Kovarnik, T.; Kidawa, M.; Moreu, J.; Flavien, V.; Fabris, E.; Lozano Martinez-Luengas, I.; Boccalatte, M.; Bosa Ojeda, F.; Arellano-Serrano, C.; Caiazzo, G.; Cirrincione, G.; Kao, H. -L.; Sanchis Fores, J.; Vignali, L.; Pereira, H.; Manzo-Silbermann, S.; Ordonez, S.; Arat Ozkan, A.; Scheller, B.; Lehtola, H.; Teles, R.; Mantis, C.; Antti, Y.; Brum Silveira, J. A.; Bessonov, I.; Zoni, R.; Savonitto, S.; Kochiadakis, G.; Alexopoulos, D.; Uribe, C. E.; Kanakakis, J.; Faurie, B.; Gabrielli, G.; Gutierrez Barrios, A.; Bachini, J. P.; Rocha, A.; Tam, F. C. -C.; Rodriguez, A.; Lukito, A. A.; Bellemain-Appaix, A.; Pessah, G.; Cortese, G.; Parodi, G.; Burgadha, M. A.; Kedhi, E.; Lamelas, P.; Suryapranata, H.; Nardin, M.; Verdoia, M.. - In: ANGIOLOGY. - ISSN 0003-3197. - 74:10(2023), pp. 987-996. [10.1177/00033197221129351]
SARS-CoV-2 Positivity, Stent Thrombosis, and 30-day Mortality in STEMI Patients Undergoing Mechanical Reperfusion
De Luca G.;Casella G.;Fabris E.;Parodi G.;Nardin M.;
2023-01-01
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.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
