Comparison of long-term outcome of patients with ST-segment elevation myocardial infarction between pre-COVID-19 and
Tuncay Kiris1, Eyüp Avci2, Tuba Ekin3
1Department of Cardiology, Ataturk Training and Research Hospital, Izmir Katip Celebi University, Izmir, Turkey.
Insights
The COVID-19 pandemic did not impact major cardiovascular and cerebrovascular events (MACCE) rates in Turkish ST-segment elevation myocardial infarction (STEMI) patients. However, COVID-19 positive STEMI patients faced higher long-term MACCE and heart failure risks.
Area of Science:
- Cardiology
- Infectious Diseases
- Public Health
Background:
- This study investigated the impact of the COVID-19 pandemic on major adverse cardiovascular and cerebrovascular events (MACCE) in ST-segment elevation myocardial infarction (STEMI) patients in Turkey.
- Utilizing data from the TURSER study, 1748 STEMI patients were analyzed, comparing cohorts from the pre-COVID-19 era (2019) and the COVID-19 era (2020).
Discussion:
- While overall MACCE rates remained similar between the pre-COVID-19 and COVID-19 eras (23% vs. 22%), a significant difference was observed in heart failure hospitalizations (12% vs. 8%).
- Crucially, within the COVID-19 era, patients who tested positive for COVID-19 exhibited substantially higher long-term MACCE rates (40% vs. 20%) and heart failure hospitalizations (43% vs. 11%) compared to their COVID-19 negative counterparts.
Key Insights:
- The COVID-19 pandemic itself did not significantly alter the incidence of MACCE in STEMI patients in Turkey.
- COVID-19 infection in STEMI patients is associated with a markedly increased risk of long-term adverse cardiovascular and cerebrovascular outcomes, including heart failure.
Outlook:
- Further research is warranted to elucidate the specific mechanisms driving the increased MACCE in COVID-19 positive STEMI patients.
- These findings underscore the importance of vigilant monitoring and tailored management strategies for STEMI patients co-infected with COVID-19.
Aims:
To compare major cardiovascular and cerebrovascular events (MACCE) rates between patients in the pre-COVID-19 era and COVID-19 era, and to assess the impact of the presence of COVID-19 (+) on long-term MACCE in ST-segment elevation myocardial infarction (STEMI) in Turkey.
Methods:
Using the TURSER study (TURKISH ST-segment elevation myocardial infarction registry) data, the current study included 1748 STEMI patients from 15 centres in Turkey. Patients were stratified into COVID-19 era (March 11st-May 15st, 2020; n = 723) or pre-COVID-19 era (March 11st-May 15st, 2019; n = 1025) cohorts. Long-term MACCE rates were compared between groups. In addition, the effect of COVID-19 positivity on long-term outcomes was evaluated. The primary outcome was the occurrence of MACCE at long-term follow-up, and the secondary outcome was hospitalization with heart failure.
Results:
The MACCE and hospitalization with heart failure rates between pre-COVID-19 era and COVID-19 era were 23% versus 22% (p = .841), and 12% versus 8% (p = .002), respectively. In the COVID-19 era, the rates of MACCE and hospitalization with heart failure COVID-19-positive versus COVID-19-negative patients were 40% versus 20%, (p < .001), and 43% versus 11% (p < .001), respectively.
Conclusion:
There was no difference between the pre-COVID-19 era and the COVID-19 era in terms of MACCE in STEMI patients in Turkey. In the COVID-19 era, STEMI patients positive for COVID-19 had a higher rate of MACCE and heart failure hospitalization at the long-term follow-up.
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