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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
18:11

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis

Published on: December 28, 2012

Angiographic and Electrocardiographic Characteristics of Patients With Non-ST-Segment Elevation Myocardial Infarction

Chase J Ellingson1,2, Jyotpal Singh2, Rosa M Marticorena3

  • 1College of Medicine, University of Saskatchewan Regina Campus, Regina, Saskatchewan, Canada.

Journal of the Society for Cardiovascular Angiography & Interventions
|July 28, 2026
PubMed

Insights

Patients with non-ST-segment elevation myocardial infarction (NSTEMI) and COVID-19 face higher mortality and procedural failure rates. This is likely due to diffuse thrombotic disease, a significant finding in this patient group.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Thrombosis

Background:

  • COVID-19 exacerbates acute coronary syndromes via inflammation, platelet activation, and endothelial injury, promoting a prothrombotic state.
  • Mortality for ST-elevation myocardial infarction (STEMI) with COVID-19 is significantly higher than in pre-pandemic eras.
  • Characterization of non-ST-segment elevation myocardial infarction (NSTEMI) patients with concurrent COVID-19 is crucial.

Purpose of the Study:

  • To characterize NSTEMI patients with COVID-19 using core laboratory adjudicated data.
  • To compare outcomes of NSTEMI patients with COVID-19 to historical cohorts.

Main Methods:

  • Retrospective analysis of 155 NSTEMI patients with laboratory-confirmed COVID-19.
  • Independent core laboratory adjudication of coronary angiograms and electrocardiograms.
  • Evaluation of in-hospital mortality, percutaneous coronary intervention (PCI) success rates, and thrombotic markers.

Main Results:

  • 8.4% in-hospital mortality; 22.3% PCI failure rate.
  • High thrombus grade (43.3%) and 25% stent thrombosis in patients with prior stents.
  • Diffuse ST changes on ECGs, including ST elevation in aVR (33%), suggesting widespread thrombotic disease.

Conclusions:

  • This study provides the first core laboratory description of NSTEMI patients with COVID-19.
  • These patients exhibit higher mortality and lower procedural success compared to prepandemic NSTEMI cohorts.
  • Diffuse thrombotic disease appears to be the primary driver of adverse outcomes in NSTEMI patients with COVID-19.
Abstract

Keywords:
COVID-19acute coronary syndromecoronavirusmyocardial infarctionnon–ST-segment elevation myocardial infarction

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