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The Challenge of High Coronary Thrombotic Events in Patients with ST-Segment Elevation Myocardial Infarction and

Larisa Anghel1,2, Bogdan-Sorin Tudurachi2, Andreea Leonte2

  • 1Internal Medicine Department, "Grigore T. Popa" University of Medicine and Pharmacy, 700503 Iași, Romania.

Journal of Clinical Medicine
|November 11, 2022
PubMed

Insights

Patients with ST-segment elevation myocardial infarction (STEMI) and coronavirus disease 2019 (COVID-19) experienced longer ischemia times and higher risks of coronary thrombosis. Findings suggest a need for aggressive antithrombotic therapy in selected COVID-19 STEMI patients.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Thrombosis

Background:

  • ST-segment elevation myocardial infarction (STEMI) is a critical cardiovascular emergency.
  • Coronavirus disease 2019 (COVID-19) has been associated with thrombotic complications.
  • Understanding the interplay between COVID-19 and STEMI is crucial for patient outcomes.

Purpose of the Study:

  • To characterize COVID-19 patients with STEMI.
  • To identify factors associated with coronary thrombosis and in-hospital mortality in these patients.
  • To compare outcomes between STEMI patients with and without COVID-19.

Main Methods:

  • Observational study comparing STEMI patients with and without COVID-19.
  • Analysis of clinical characteristics, ischemia times, and treatment strategies.
  • Evaluation of factors predicting coronary thrombosis, including platelet levels and D-dimers.

Main Results:

  • COVID-19 patients with STEMI presented more frequently with dyspnea and cardiogenic shock.
  • COVID-19 patients experienced longer ischemia times and were more likely to undergo delayed angiography.
  • Elevated D-dimers (>740 ng/ml) predicted higher coronary thrombosis risk; platelet levels showed an inverse correlation.

Conclusions:

  • COVID-19 is associated with increased thrombotic risk and adverse outcomes in STEMI patients.
  • Novel findings highlight the predictive value of D-dimers for coronary thrombosis in this population.
  • Further research is warranted to explore more aggressive antithrombotic strategies for selected COVID-19 STEMI patients.

Keywords:
COVID-19SARS-CoV-2STEMIcoronary diseasein-hospital mortalitythrombotic events

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