Jorge Solano-López1, José Luis Zamorano2, Ana Pardo Sanz1, Ignacio Amat-Santos3, Fernando Sarnago4, Enrique Gutiérrez Ibañes5, Juan Sanchis6, Juan Ramón Rey Blas7, Joan Antoni Gómez-Hospital8, Sandra Santos Martínez9, Nicolás Manuel Maneiro-Melón10, Roberto Mateos Gaitán11, Jessika González D'Gregorio12, Luisa Salido2, José L Mestre1, Marcelo Sanmartín2, Ángel Sánchez-Recalde13. 1. Departamento de Cardiología, Hospital Universitario Ramón y Cajal, Madrid, Spain. 2. Departamento de Cardiología, Hospital Universitario Ramón y Cajal, Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain. 3. Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain; Departamento de Cardiología, Hospital Clínico Universitario de Valladolid, Instituto de Ciencias del Corazón (ICICOR), Valladolid, Spain. 4. Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain; Departamento de Cardiología, Hospital Universitario 12 de Octubre, Madrid, Spain. 5. Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain; Departamento de Cardiología, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain. 6. Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain; Departamento de Cardiología Intervencionista, Hospital Clínic i Universitari de València - Instituto de Investigación Sanitaria INCLIVA, Valencia, Spain. 7. Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain; Departamento de Cardiología, Hospital Universitario La Paz, Madrid, Spain. 8. Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain; Departamento de Cardiología, Hospital Universitario Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain. 9. Departamento de Cardiología, Hospital Clínico Universitario de Valladolid, Instituto de Ciencias del Corazón (ICICOR), Valladolid, Spain. 10. Departamento de Cardiología, Hospital Universitario 12 de Octubre, Madrid, Spain. 11. Departamento de Cardiología, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain. 12. Departamento de Cardiología Intervencionista, Hospital Clínic i Universitari de València - Instituto de Investigación Sanitaria INCLIVA, Valencia, Spain. 13. Departamento de Cardiología, Hospital Universitario Ramón y Cajal, Madrid, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain. Electronic address: asrecalde@hotmail.com.
Abstract
INTRODUCTION AND OBJECTIVES: Despite advances in treatment, patients with acute myocardial infarction (AMI) still exhibit unfavorable short- and long-term prognoses. In addition, there is scant evidence about the clinical outcomes of patients with AMI and coronavirus disease 2019 (COVID-19). The objective of this study was to describe the clinical presentation, complications, and risk factors for mortality in patients admitted for AMI during the COVID-19 pandemic. METHODS: This prospective, multicenter, cohort study included all consecutive patients with AMI who underwent coronary angiography in a 30-day period corresponding chronologically with the COVID-19 outbreak (March 15 to April 15, 2020). Clinical presentations and outcomes were compared between COVID-19 and non-COVID-19 patients. The effect of COVID-19 on mortality was assessed by propensity score matching and with a multivariate logistic regression model. RESULTS: In total, 187 patients were admitted for AMI, 111 with ST-segment elevation AMI and 76 with non-ST-segment elevation AMI. Of these, 32 (17%) were diagnosed with COVID-19. GRACE score, Killip-Kimball classification, and several inflammatory markers were significantly higher in COVID-19-positive patients. Total and cardiovascular mortality were also significantly higher in COVID-19-positive patients (25% vs 3.8% [P <.001] and 15.2% vs 1.8% [P=.001], respectively). GRACE score> 140 (OR, 23.45; 95%CI, 2.52-62.51; P=.005) and COVID-19 (OR, 6.61; 95%CI, 1.82-24.43; P=.02) were independent predictors of in-hospital death. CONCLUSIONS: During this pandemic, a high GRACE score and COVID-19 were independent risk factors associated with higher in-hospital mortality.
INTRODUCTION AND OBJECTIVES: Despite advances in treatment, patients with acute myocardial infarction (AMI) still exhibit unfavorable short- and long-term prognoses. In addition, there is scant evidence about the clinical outcomes of patients with AMI and coronavirus disease 2019 (COVID-19). The objective of this study was to describe the clinical presentation, complications, and risk factors for mortality in patients admitted for AMI during the COVID-19 pandemic. METHODS: This prospective, multicenter, cohort study included all consecutive patients with AMI who underwent coronary angiography in a 30-day period corresponding chronologically with the COVID-19 outbreak (March 15 to April 15, 2020). Clinical presentations and outcomes were compared between COVID-19 and non-COVID-19patients. The effect of COVID-19 on mortality was assessed by propensity score matching and with a multivariate logistic regression model. RESULTS: In total, 187 patients were admitted for AMI, 111 with ST-segment elevation AMI and 76 with non-ST-segment elevation AMI. Of these, 32 (17%) were diagnosed with COVID-19. GRACE score, Killip-Kimball classification, and several inflammatory markers were significantly higher in COVID-19-positive patients. Total and cardiovascular mortality were also significantly higher in COVID-19-positive patients (25% vs 3.8% [P <.001] and 15.2% vs 1.8% [P=.001], respectively). GRACE score> 140 (OR, 23.45; 95%CI, 2.52-62.51; P=.005) and COVID-19 (OR, 6.61; 95%CI, 1.82-24.43; P=.02) were independent predictors of in-hospital death. CONCLUSIONS: During this pandemic, a high GRACE score and COVID-19 were independent risk factors associated with higher in-hospital mortality.
Authors: Lucas Gomes Santos; Regicley Vieira da Silva; Thiago Cavalcanti Leal; José Emerson Xavier; Elaine Virgínia Martins de Souza Figueiredo; João Paulo Silva de Paiva; Leonardo Feitosa da Silva; Carlos Alberto de Oliveira Rocha; Bruno Eduardo Bastos Rolim Nunes; Gibson Barros de Almeida Santana; Tânia Rita Moreno de Oliveira Fernandes; Francisco de Assis Costa; Márcio Bezerra-Santos; Rodrigo Feliciano do Carmo; Anderson da Costa Armstrong; Carlos Dornels Freire de Souza Journal: Curr Probl Cardiol Date: 2022-04-21 Impact factor: 16.464