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Tytuł:
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Epidemiology and Management of ST-Segment-Elevation Myocardial Infarction in Patients With COVID-19: A Report From the American Heart Association COVID-19 Cardiovascular Disease Registry.
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Autorzy:
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Bhatt AS; Levine Cardiac Intensive Care Unit Thrombolysis in Myocardial Infarction (TIMI) Study Group Cardiovascular Division Department of Medicine Brigham and Women's Hospital and Harvard Medical School Boston MA.
Varshney AS; Levine Cardiac Intensive Care Unit Thrombolysis in Myocardial Infarction (TIMI) Study Group Cardiovascular Division Department of Medicine Brigham and Women's Hospital and Harvard Medical School Boston MA.
Goodrich EL; Levine Cardiac Intensive Care Unit Thrombolysis in Myocardial Infarction (TIMI) Study Group Cardiovascular Division Department of Medicine Brigham and Women's Hospital and Harvard Medical School Boston MA.
Gong J; Department of Medicine Brigham and Women's Hospital and Harvard Medical School Boston MA.
Ginder C; Department of Medicine Brigham and Women's Hospital and Harvard Medical School Boston MA.
Senman BC; Department of Medicine Brigham and Women's Hospital and Harvard Medical School Boston MA.
Johnson M; Harvard Medical School Boston MA.
Butler K; Levine Cardiac Intensive Care Unit Thrombolysis in Myocardial Infarction (TIMI) Study Group Cardiovascular Division Department of Medicine Brigham and Women's Hospital and Harvard Medical School Boston MA.
Woolley AE; Division of Infectious Disease Department of Medicine Brigham and Women's Hospital and Harvard Medical School Boston MA.
de Lemos JA; Division of Cardiology Department of Internal Medicine University of Texas Southwestern Medical Center and Parkland Health and Hospital System Dallas TX.
Morrow DA; Levine Cardiac Intensive Care Unit Thrombolysis in Myocardial Infarction (TIMI) Study Group Cardiovascular Division Department of Medicine Brigham and Women's Hospital and Harvard Medical School Boston MA.
Bohula EA; Levine Cardiac Intensive Care Unit Thrombolysis in Myocardial Infarction (TIMI) Study Group Cardiovascular Division Department of Medicine Brigham and Women's Hospital and Harvard Medical School Boston MA.
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Źródło:
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Journal of the American Heart Association [J Am Heart Assoc] 2022 May 03; Vol. 11 (9), pp. e024451. Date of Electronic Publication: 2022 Apr 26.
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Typ publikacji:
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Journal Article; Research Support, Non-U.S. Gov't; Research Support, N.I.H., Extramural
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Język:
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English
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Imprint Name(s):
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Original Publication: Oxford : Wiley-Blackwell
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MeSH Terms:
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COVID-19*/epidemiology
COVID-19*/therapy
Cardiovascular Diseases*/epidemiology
Myocardial Infarction*/epidemiology
ST Elevation Myocardial Infarction*/diagnosis
ST Elevation Myocardial Infarction*/epidemiology
ST Elevation Myocardial Infarction*/therapy
American Heart Association ; Hospital Mortality ; Humans ; Pandemics ; Registries ; United States/epidemiology
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References:
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Grant Information:
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T32 HL007604 United States HL NHLBI NIH HHS
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Contributed Indexing:
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Keywords: ST‐segment–elevation myocardial infarction; acute myocardial infarction; coronavirus disease 2019
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Entry Date(s):
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Date Created: 20220426 Date Completed: 20220504 Latest Revision: 20220725
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Update Code:
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20240104
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PubMed Central ID:
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PMC9238583
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DOI:
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10.1161/JAHA.121.024451
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PMID:
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35470683
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Background Early reports from the COVID-19 pandemic identified coronary thrombosis leading to ST-segment-elevation myocardial infarction (STEMI) as a complication of COVID-19 infection. However, the epidemiology of STEMI in patients with COVID-19 is not well characterized. We sought to determine the incidence, diagnostic and therapeutic approaches, and outcomes in STEMI patients hospitalized for COVID-19. Methods and Results Patients with data on presentation ECG and in-hospital myocardial infarction were identified from January 14, 2020 to November 30, 2020, from 105 sites participating in the American Heart Association COVID-19 Cardiovascular Disease Registry. Patient characteristics, resource use, and clinical outcomes were summarized and compared based on the presence or absence of STEMI. Among 15 621 COVID-19 hospitalizations, 54 (0.35%) patients experienced in-hospital STEMI. Among patients with STEMI, the majority (n=40, 74%) underwent transthoracic echocardiography, but only half (n=27, 50%) underwent coronary angiography. Half of all patients with COVID-19 and STEMI (n=27, 50%) did not undergo any form of primary reperfusion therapy. Rates of all-cause shock (47% versus 14%), cardiac arrest (22% versus 4.8%), new heart failure (17% versus 1.4%), and need for new renal replacement therapy (11% versus 4.3%) were multifold higher in patients with STEMI compared with those without STEMI ( P <0.050 for all). Rates of in-hospital death were 41% in patients with STEMI, compared with 16% in those without STEMI ( P <0.001). Conclusions STEMI in hospitalized patients with COVID-19 is rare but associated with poor in-hospital outcomes. Rates of coronary angiography and primary reperfusion were low in this population of patients with STEMI and COVID-19. Adaptations of systems of care to ensure timely contemporary treatment for this population are needed.
