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Thrombus Burden and Outcomes in Patients With COVID-19 Presenting With STEMI Across the Pandemic

Krishnaraj S Rathod1, Zhi Teoh2, Angelos Tyrlis2

  • 1Department of Cardiology, Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom; Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University of London, London, United Kingdom.

Journal of the American College of Cardiology
|June 21, 2023
PubMed

Insights

Outcomes for ST-segment elevation myocardial infarction (STEMI) patients with COVID-19 have improved significantly since the pandemic

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Public Health

Background:

  • Previous reports indicated worse outcomes for ST-segment elevation myocardial infarction (STEMI) patients with concurrent COVID-19 during the initial outbreak.
  • Limited data exists comparing STEMI patient outcomes across different COVID-19 pandemic waves.

Purpose of the Study:

  • To compare demographic, procedural, angiographic, and clinical outcomes of STEMI patients with and without COVID-19 across pandemic waves.
  • To assess changes in STEMI patient characteristics and outcomes over time during the COVID-19 pandemic.

Main Methods:

  • Single-center observational study of 1,269 STEMI patients treated with percutaneous coronary intervention (January 2020 - October 2022).
  • COVID-19 positive STEMI patients were stratified into three groups based on pandemic wave.
  • Comparison of outcomes between COVID-19 positive and negative STEMI patients, and across different pandemic waves.

Main Results:

  • Initially, COVID-19 positive STEMI patients had higher rates of cardiac arrest, increased thrombus burden, larger infarcts, and poorer outcomes.
  • By the third wave, outcomes for COVID-19 positive STEMI patients were comparable to COVID-19 negative patients.
  • Poorer outcomes in later waves were primarily observed in unvaccinated individuals.

Conclusions:

  • Clinical characteristics, angiographic features, and outcomes of STEMI patients with COVID-19 have evolved throughout the pandemic.
  • Recent pandemic waves show no difference in outcomes for vaccinated STEMI patients compared to non-COVID-19 populations.
  • Vaccination status is a key factor influencing outcomes in STEMI patients with COVID-19.
Abstract

Keywords:
COVID-19ECGPCISTEMI

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