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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
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COVID-19 infected ST-Elevation myocardial infarction in India (COSTA INDIA)

Abdullakutty Jabir1, Geevar Zachariah2, Padinhare Purayil Mohanan3

  • 1Lisie Hospital, Kochi, Kerala, India.

Indian Heart Journal
|May 25, 2023
PubMed

Insights

COVID-19 infection in ST-elevation myocardial infarction (STEMI) patients did not increase in-hospital mortality but led to worse composite outcomes. Fewer STEMI patients with COVID-19 received reperfusion therapy and primary PCI.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Public Health

Background:

  • ST-elevation myocardial infarction (STEMI) is a critical cardiovascular emergency.
  • The impact of COVID-19 co-infection on STEMI presentation, management, and outcomes requires thorough investigation.

Purpose of the Study:

  • To compare the clinical characteristics, treatment strategies, and in-hospital outcomes of STEMI patients with and without COVID-19.
  • To identify disparities in care and associated risks for STEMI patients co-infected with COVID-19.

Main Methods:

  • A retrospective, multicenter observational registry study was conducted across tertiary care hospitals in India.
  • Data from 410 COVID-19 positive STEMI patients were compared with 799 age- and sex-matched COVID-19 negative STEMI patients.
  • The primary endpoint included a composite of in-hospital mortality, re-infarction, heart failure, and stroke.

Main Results:

  • The composite endpoint of death/reinfarction/stroke/heart failure was significantly higher in COVID-19 positive STEMI patients (27.1% vs. 20.7%, p=0.01).
  • In-hospital mortality rates did not differ significantly between the groups (8.0% vs. 5.8%, p=0.13).
  • COVID-19 positive STEMI patients received significantly less reperfusion treatment (60.7% vs. 71.1%) and primary percutaneous coronary intervention (PCI) (15.4% vs. 23.4%).

Conclusions:

  • Despite lower rates of reperfusion and primary PCI, COVID-19 co-infection with STEMI did not result in significantly higher in-hospital mortality.
  • However, COVID-19 positive STEMI patients experienced a worse composite outcome, indicating a need for optimized management strategies.
  • The study highlights potential barriers to timely and effective treatment for STEMI patients during the COVID-19 pandemic.
Abstract

Keywords:
COVID positive STEMIMI during COVIDSTEMI and COVIDSTEMI during COVIDSTEMI management

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