Characteristics and Outcomes in Patients Presenting With COVID-19 and ST-Segment Elevation Myocardial Infarction

Area of Science:

• Cardiology
• Infectious Diseases
• Critical Care Medicine

Background:

• Limited data exists on the clinical characteristics and outcomes of patients with ST-segment elevation myocardial infarction (STEMI) who also have SARS-CoV-2 (COVID-19).
• Understanding these outcomes is crucial for effective patient management.

Purpose of the Study:

• To describe the clinical features and outcomes of COVID-19 patients presenting with STEMI.
• To identify potential challenges and inform management strategies for this patient population.

Main Methods:

• A multicenter retrospective study was conducted across 4 countries (Italy, Lithuania, Spain, Iraq).
• Charts of 78 patients with symptomatic COVID-19 and STEMI, admitted between February 1, 2020, and April 15, 2020, were reviewed.
• Patients were analyzed based on treatment received: primary Percutaneous Coronary Intervention (PCI) or fibrinolytic therapy.

Main Results:

• The study included 78 patients (63% male, median age 65 years) with high comorbidity burden.
• Among patients treated with primary PCI (n=19), 21% experienced stent thrombosis, 42% required intubation, and 42% needed cardiac resuscitation.
• Patients treated with fibrinolytic therapy (n=59) had a 7% mortality rate, with 85% achieving successful reperfusion.
• Overall, 11% of patients died during hospitalization, and 9% suffered a hemorrhagic stroke.

Conclusions:

• This is the largest case series to date of COVID-19 positive patients presenting with STEMI.
• A high rate of stent thrombosis was observed in patients treated with primary PCI, suggesting a need to adapt STEMI management protocols for COVID-19 patients.
• Further research is warranted to optimize treatment strategies and improve outcomes for this vulnerable group.