In-hospital outcomes of patients with ST-segment elevation myocardial infarction and COVID-19.

Rodriguez-Leor, Oriol; Cid Alvarez, Ana Belen; de Prado, Armando Perez; Rossello, Xavier; Ojeda, Soledad; Serrador, Ana; López-Palop, Ramon; Martin-Moreiras, Javier; Rumoroso, Jose Ramon; Cequier, Angel; Ibáñez, Borja; Cruz-González, Ignatio; Romaguera, Rafael; Moreno, Raúl

AIMS 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 2 different cohorts, according to whether they had Covid-19. Among 1010 consecutive STEMI patients, 91 were identified as Covid-19 (10.9%). With the exception of smoking status (more frequent in non-Covid-19) and previous coronary artery disease (more frequent in Covid-19), clinical characteristics were similar between 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 IIbIIIa inhibitors 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 ischemic time: OR (95% CI) = 4.85 (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, stent thrombosis and cardiogenic shock development after PCI in patients with STEMI and Covid-19 in comparison with contemporaneous non-Covid-19 STEMI patients.