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Published on: December 19, 2020
Angiographic and Clinical Profile of Patients With COVID-19 Referred for Coronary Angiography During SARS-CoV-2
J M Montero-Cabezas1, J G Córdoba-Soriano2, F Díez-Delhoyo3
1Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands.
Insights
Patients with COVID-19 undergoing coronary angiography often present with STEMI and comorbidities. Despite mild illness, major adverse cardiovascular events were high, primarily due to noncardiac deaths.
Area of Science:
- Cardiology
- Infectious Diseases
- Public Health
Background:
- Limited data exists on the angiographic characteristics and outcomes of patients with coronavirus disease 2019 (COVID-19) undergoing coronary angiography (CAG).
- Understanding these profiles is crucial for managing cardiovascular complications during the pandemic.
Purpose of the Study:
- To analyze the clinical profile, angiographic findings, and in-hospital outcomes of COVID-19 patients referred for CAG.
- To identify predictors of adverse events in this population.
Main Methods:
- An observational study involving 57 COVID-19 patients from 10 European centers who underwent CAG.
- Data collected included demographics, comorbidities, indication for CAG, COVID-19 severity, angiographic findings, and 40-day major adverse cardiovascular events (MACE).
Main Results:
- The most frequent indication for CAG was ST-segment elevation myocardial infarction (STEMI) (58%).
- A culprit lesion was identified in 79% of patients, with 42% showing a high thrombus burden and 7% experiencing stent thrombosis.
- At 40 days, 28% of patients experienced MACE, predominantly noncardiac deaths (92%).
Conclusions:
- COVID-19 patients referred for CAG during the pandemic's first wave often presented with STEMI and comorbidities.
- Despite generally non-critical COVID-19 illness, the incidence of MACE was substantial, driven mainly by noncardiac mortality.
Abstract:
Data regarding angiographic characteristics, clinical profile, and inhospital outcomes of patients with coronavirus disease 2019 (COVID-19) referred for coronary angiography (CAG) are scarce. This is an observational study analyzing confirmed patients with COVID-19 referred for CAG from 10 European centers. We included 57 patients (mean age: 66 ± 15 years, 82% male) , of whom 18% had previous myocardial infarction (MI) and 29% had renal insufficiency and chronic pulmonary disease. ST-segment elevation myocardial infarction (STEMI) was the most frequent indication for CAG (58%). Coronavirus disease 2019 was confirmed after CAG in 86% and classified as mild in 49%, with 21% fully asymptomatic. A culprit lesion was identified in 79% and high thrombus burden in 42%; 7% had stent thrombosis. At 40 days follow-up, 16 (28%) patients experienced a major adverse cardiovascular event (MACE): 12 deaths (92% noncardiac), 1 MI, 2 stent thrombosis, and 1 stroke. In an European multicenter registry, patients with confirmed COVID-19 infection referred for CAG during the first wave of the severe acute respiratory syndrome coronavirus 2 pandemic presented mostly with STEMI and were predominantly males with comorbidities. Severity of COVID-19 was in general noncritical and 21% were asymptomatic at the time of CAG. Culprit coronary lesions with high thrombus burden were frequently identified, with a rate of stent thrombosis of 7%. The incidence of MACE at 40 days was high (28%), mostly due to noncardiac death.
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