Should a recent SARS-CoV-2 infection be considered a risk or prognostic factor for ST-segment elevation myocardial
Kietseé A Díaz-Domínguez1, Andrés Cruz-Melendez2, Luis M Amezcua-Castillo3
1Department of Immunology, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México.
Insights
Recent SARS-CoV-2 infection may trigger ST-elevation myocardial infarction (STEMI) in patients with fewer traditional risk factors. However, the infection did not alter STEMI severity or in-hospital outcomes.
Area of Science:
- Cardiology
- Infectious Diseases
- Public Health
Background:
- Emerging evidence suggests a link between SARS-CoV-2 infection and cardiovascular complications.
- ST-segment elevation myocardial infarction (STEMI) is a critical manifestation of acute coronary syndrome.
Purpose of the Study:
- To investigate if recent SARS-CoV-2 infection independently acts as a risk or prognostic factor for STEMI.
- To compare cardiovascular risk factors, STEMI severity, and clinical outcomes in STEMI patients with and without recent SARS-CoV-2 infection.
Main Methods:
- Observational study of unvaccinated STEMI patients confirmed by cardiac catheterization.
- SARS-CoV-2 infection identified via serum IgG or positive PCR tests.
- Comparison of baseline risk factors, STEMI severity, catheterization findings, and major adverse cardiovascular events (MACE) between infected and uninfected groups.
Main Results:
- 16% of STEMI patients had a recent SARS-CoV-2 infection.
- Infected patients exhibited significantly lower rates of hypertension and a trend towards fewer comorbidities.
- No significant differences were observed in STEMI severity, atherosclerotic burden, or MACE during hospitalization.
Conclusions:
- Recent SARS-CoV-2 infection may facilitate STEMI onset, particularly in individuals with fewer traditional cardiovascular risk factors.
- The infection does not appear to influence the clinical presentation or in-hospital prognosis of STEMI.
Objective:
The aim of the study was to assess whether a recent SARS-CoV-2 infection could by itself be a risk or prognostic factor for ST-segment elevation myocardial infarction (STEMI).
Method:
An observational study in unvaccinated patients with STEMI confirmed by cardiac catheterization was conducted. A recent or concurrent SARS-CoV-2 infection was identified by the presence of serum IgG against the nucleocapsid protein, or a positive polymerase chain reaction test on nasopharyngeal swabs. Baseline cardiovascular risk factors, clinical STEMI severity, main catheterization findings, and occurrence of major adverse cardiovascular events (MACE) during hospitalization were compared between study subgroups.
Results:
Of a total of 89 patients recruited, 14 (16%) had a recent SARS-CoV-2 infection. Patients with STEMI and recent SARS-CoV-2 infection had a markedly lower frequency of high blood pressure (20% versus 55%; P = 0.03) as well as a tendency to have fewer comorbidities. Regarding the clinical presentation, there were no differences in the severity of the STEMI. Furthermore, the main findings during cardiac catheterization including the atherosclerotic burden and the number of vessels affected, as well as the occurrence of MACE during follow-up, were not significantly different between the groups.
Conclusions:
A recent SARS-CoV-2 infection appears to facilitate the triggering of STEMI, as these patients have fewer traditional cardiovascular risk factors than their uninfected counterparts. However, this does not seem to affect the clinical presentation or the in-hospital course of STEMI patients.
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