COVID-19の診断とSTセグメント上昇心筋梗塞で入院した患者の入院死亡率との関連
Marwan Saad1, Kevin F Kennedy2, Hafiz Imran1
1Division of Cardiology, Warren Alpert Medical School of Brown University, Lifespan Cardiovascular Institute, Providence, Rhode Island.
JAMA
|October 29, 2021
まとめ
ST上昇性心筋梗塞 (STEMI) とCOVID-19の患者は,COVID-19のない患者と比較して,病院での死亡率が著しく高かった. これは,STEMI患者の結果に対するCOVID-19の重大な影響を強調しています.
科学分野:
- 心臓病科
- 感染症
- 公衆衛生
背景:
- ST上昇性心筋梗塞 (STEMI) とCOVID-19の交差点に関する研究は限られている.
- 同時期にCOVID-19を患っているSTEMI患者のアウトカムを理解することは極めて重要です.
研究 の 目的:
- COVID-19 感染した STEMI 患者の特徴,治療,結果を比較する.
- STEMI患者の入院死亡率に対するCOVID-19の影響を評価する.
主な方法:
- 米国の509のセンターから80,000人以上の成人のSTEMI患者を対象とした遡及コホート研究 (2019年1月~2020年12月).
- 傾向のマッチングは,STEMIでの感染が活発な患者と,前年のCOVID-19のない患者とを比較するために使用されました.
- 主なアウトカムは入院死亡率でした.
主要な成果:
- 病院外でのSTEMI患者では,COVID-19は病院内での死亡率 (15.2%対11.2%) の有意な増加と関連していました.
- 病院内のSTEMI患者の場合,COVID-19は病院内の死亡率 (78.5%対46.1%) を大幅に増加させた.
- 入院中のSTEMIとCOVID-19の患者は冠動脈手術を受ける可能性が低い.
結論:
- STEMI患者の同時COVID-19診断は,病院での死亡率の増加と有意に関連しています.
- この増加した死亡率を誘発するメカニズムを明らかにするためにさらなる研究が必要である.
- これらの発見は,COVID-19のSTEMI患者のリスクの高まりを強調しています.
さらに関連する動画
04:41Digital PCR for Quantifying Circulating MicroRNAs in Acute Myocardial Infarction and Cardiovascular Disease
Published on: July 3, 2018
8.3K
05:41Left Anterior Descending Coronary Artery Ligation for Ischemia-Reperfusion Research: Model Improvement via Technical Modifications and Quality Control
Published on: December 16, 2022
3.8K
関連する概念動画
01:30Acute Coronary Syndrome I: Introduction
116
Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
116
01:30Acute Coronary Syndrome III: Diagnostic Studies
44
Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
44
01:14Myocarditis III: Medical Management
31
Myocarditis: Comprehensive Medical ManagementMyocarditis, the heart muscle inflammation, requires a comprehensive medical management strategy that addresses the underlying cause, provides supportive care, manages symptoms, and reduces cardiac workload.Infections and Autoimmune CausesAdminister appropriate antimicrobial therapy when an infectious agent causes myocarditis. For instance, penicillin treats infections caused by Group A Streptococcus. In cases where autoimmune processes are...
31
01:27Myocarditis II: Clinical Features and Diagnostic Tests
43
Myocarditis is an inflammation of the heart muscle. The symptoms vary widely, encompassing asymptomatic presentations to severe, acute manifestations.Clinical PresentationAsymptomatic cases: In some instances, myocarditis may be asymptomatic, with the infection resolving without intervention. These cases often go undetected unless discovered incidentally through diagnostic imaging or tests conducted for other reasons.General Early Symptoms: Early symptoms of myocarditis are non-specific and can...
43
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
79
The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
79
01:21Myocarditis I: Introduction
64
Myocarditis is inflammation of the myocardium, which is the muscular layer of the heart.EtiologyMyocarditis has a diverse etiology, including a wide range of infectious and non-infectious causes:Infectious CausesViral: Common viruses include Coxsackie A and B, adenovirus, parvovirus B19, enteroviruses, and influenza A.Bacterial: Examples include infections caused by Streptococcus, Staphylococcus, and Mycoplasma species.Rickettsial: Infections like Rocky Mountain spotted fever can result in...
64