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Differences in door-to-balloon time and outcomes in SARS-CoV-2-positive ST-segment elevation myocardial infarction

Qinxue Bao1, Rui Li1, Chengfeng Wang1

  • 1Department of Cardiology, Dayi County People's Hospital, Chengdu, Sichuan, China.

Medicine
|October 13, 2023
PubMed

Insights

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is linked to longer door-to-balloon times for ST-elevation myocardial infarction (STEMI) patients. This meta-analysis found SARS-CoV-2 positive STEMI patients also experienced higher in-hospital mortality rates.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Public Health

Background:

  • The coronavirus disease 2019 (COVID-19) pandemic has strained healthcare systems globally.
  • Patients with cardiovascular diseases are particularly vulnerable.
  • Limited data exists on the impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI).

Approach:

  • A systematic literature search was conducted across multiple databases until April 30, 2023.
  • Meta-analysis was performed on 5 eligible studies (307 cases, 1804 controls) using random-effects models.
  • Sensitivity and trial sequential analyses were employed to ensure robustness of findings.

Key Points:

  • SARS-CoV-2 positive STEMI patients had significantly longer door-to-balloon times (OR 6.31).
  • Increased use of glycoprotein IIb/IIIa inhibitors (OR 2.71) and worse Thrombolysis in Myocardial Infarction (TIMI) blood flow (OR 0.48) were observed.
  • In-hospital mortality was substantially higher in SARS-CoV-2 positive patients (OR 5.16).

Conclusions:

  • SARS-CoV-2 positivity is a significant risk factor for prolonged door-to-balloon times in STEMI patients undergoing primary PCI.
  • COVID-19 infection is associated with increased in-hospital mortality in this patient group.
  • Factors like age, gender, and comorbidities did not show significant association with STEMI development in SARS-CoV-2 patients.
Abstract

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