Patients With ST-Segment Elevation Myocardial Infarction and Cerebrovascular Accidents: Impact of COVID-19
Sharvil Patel1, Mahmoud Ballout1, Sandus Khan1
1Internal Medicine Department, Northeast Georgia Medical Center, Gainesville, GA, USA.
Insights
COVID-19 vaccination was linked to lower mortality for patients hospitalized with ST-segment elevation myocardial infarction (STEMI) and cerebrovascular accidents (CVA). Vaccination offers a protective effect against adverse outcomes in these high-risk cardiovascular events.
Area of Science:
- Cardiology
- Infectious Diseases
- Public Health
Background:
- Coronavirus disease 2019 (COVID-19) is linked to pro-inflammatory states and severe health issues, including ST-segment elevation myocardial infarction (STEMI) and cerebrovascular accidents (CVA).
- Emerging evidence suggests that COVID-19 vaccination may mitigate the severe health impacts of COVID-19 infections.
Purpose of the Study:
- To investigate the association between COVID-19 vaccination status and mortality rates among patients hospitalized with STEMI or CVA.
- To determine if COVID-19 vaccination influences in-hospital mortality in patients experiencing STEMI or CVA.
Main Methods:
- Retrospective comparative analysis of 3,050 patients admitted with STEMI or CVA between April 2019 and March 2022.
- Patients categorized into pre-COVID, COVID, and post-COVID periods; analyzed using Chi-square and multinominal logistic regression to assess mortality predictors.
Main Results:
- COVID-19 vaccination was associated with significantly lower in-hospital mortality (OR = 0.51, P < 0.027) in STEMI and CVA patients.
- Increased mortality risk observed with age, atrial fibrillation (AFIB), and chronic heart failure (CHF).
- Coronary artery disease (CAD) and hyperlipidemia were associated with reduced mortality.
Conclusions:
- COVID-19 vaccination demonstrates a protective effect, reducing mortality in patients hospitalized with STEMI and CVA.
- Pre-existing cardiovascular conditions like CAD and hyperlipidemia are also linked to better outcomes in this patient cohort.
Background:
Coronavirus disease 2019 (COVID-19) infection is associated with proinflammatory states and adverse health outcomes such as ST-segment elevation myocardial infarction (STEMI) and cerebrovascular accidents (CVA). Limited evidence suggests that COVID-19 vaccination may decrease the adverse impact of COVID-19 infections. This study was designed to determine if patients who received COVID-19 vaccination had lower mortality from STEMI and CVA.
Methods:
This is a retrospective comparative analysis of 3,050 patients, who were admitted to the hospital and diagnosed with STEMI or CVA between April 1, 2019, and April 1, 2022. Patients were divided into three different timeframes: pre-COVID (April 1, 2019, to March 31, 2020), COVID (April 1, 2020 to March 31, 2021), and post-COVID (April 1, 2021 to March 31, 2022). Chi-square analysis was completed to analyze associations between STEMI, CVA, and vaccination status. A multinominal logistic regression was used to determine significant predictors for in-hospital mortality.
Results:
A total of 3,050 patients were admitted (1,873 STEMI and 1,177 CVA). STEMI accounted for about 60% of cases in each of the three time periods. There was no statistical difference in STEMI or CVA percentages in the three time periods. There was increased mortality in STEMI and CVA patients (odds ratio (OR) = 11.4; P < 0.001), but patients who received the COVID-19 vaccine were less likely to die (OR = 0.51, 95% confidence interval (CI): 0.28 - 0.93; P < 0.027) when compared to those who were unvaccinated. There was increased risk of death in patients with atrial fibrillation (AFIB) (OR = 2.43; P < 0.001) and chronic heart failure (CHF) (OR = 1.76; P = 0.004). There was increased mortality risk associated with age (OR =1.03; P = 0.001). Patients with coronary artery disease (CAD) (OR = 0.45; P = 0.014) and hyperlipidemia (OR = 0.29; P < 0.001) were less likely to die.
Conclusions:
Vaccination against COVID-19 was associated with reduced mortality rates in patients hospitalized with STEMI and CVA. Patients with pre-existing cardiovascular comorbidities such as CAD and hyperlipidemia also had lower mortality.
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