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SARS-CoV-2 Positivity, Stent Thrombosis, and 30-day Mortality in STEMI Patients Undergoing Mechanical Reperfusion

2022; SAGE Publishing; Volume: 74; Issue: 10 Linguagem: Inglês

10.1177/00033197221129351

1940-1574

Giuseppe De Luca, Magdy Algowhary, Berat Uğuz, Dinaldo Cavalcanti de Oliveira, V. I. Ganyukov, Zan Zimbakov, Miha Čerček, Lisette Okkels Jensen, Poay Huan Loh, Lucian Câlmâc, Gerard Roura Ferrer, Alexandre Schaan de Quadros, Marek Milewski, Fortunato Scotto di Uccio, Clemens von Birgelen, Francesco Versaci, Jurriën M. ten Berg, Gianni Casella, Aaron Wong Sung Lung, Petr Kala, José Luis Díez Gil, Xavier Carrillo, Maurits T. Dirksen, Víctor Manuel Becerra‐Muñoz, Michael Lee, Dafsah Arifa Juzar, Rodrigo de Moura Joaquim, Ciro De Simone, Davor Miličić, Periklis Davlouros, Nikola Bakraceski, Filippo Zilio, Luca Donazzan, Adriaan O. Kraaijeveld, Gennaro Galasso, Árpád Lux, Lucia Marinucci, Vincenzo Guiducci, Maurizio Menichelli, Alessandra Scoccia, Aylin Hatice Yamaç, Kadir Uğur Mert, Xacobe Flores‐Ríos, Tomáš Kovárník, Michał Kidawa, José Moreu, Flavien Vincent, Enrico Fabris, Íñigo Lozano, Marco Boccalatte, Francisco Bosa Ojeda, Carlos Arellano Serrano, Gianluca Caiazzo, Giuseppe Cirrincione, Hsien‐Li Kao, Juan Sanchís, Luigi Vignali, Hélder Pereira, Stephane Manzo-Silbermann, Santiago Ordóñez, Alev Arat Özkan, Bruno Scheller, Heidi Lehtola, Rui Campante Teles, Christos Mantis, Ylitalo Antti, João Silveira, И. С. Бессонов, Rodrigo Zoni, Stefano Savonitto, George Kochiadakis, Dimitrios Alexopoulos, C. Uribe, John Kanakakis, Benjamin Faurie, Gabriele Gabrielli, Alejandro Gutiérrez, Juan Pablo Bachini, Alex Rocha, Frankie Chor-Cheung Tam, Alfredo Rodriguez, Antonia Anna Lukito, Anne Bellemain-Appaix, Gustavo Pessah, Giuliana Cortese, Guido Parodi, Mohammed Abed Burgadha, Elvin Kedhi, Pablo Lamelas, Harry Suryapranata, Matteo Nardin, Monica Verdoia,

Acute Myocardial Infarction Research

SARS-Cov-2 has been suggested to promote thrombotic complications and higher mortality. The aim of the present study was to evaluate the impact of SARS-CoV-2 positivity on in-hospital outcome and 30-day mortality in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI) enrolled in the International Survey on Acute Coronary Syndromes ST-segment elevation Myocardial Infarction (ISACS-STEMI COVID-19 registry. The 109 SARS-CoV-2 positive patients were compared with 2005 SARS-CoV-2 negative patients. Positive patients were older (P = .002), less often active smokers (P = .002), and hypercholesterolemic (P = .006), they presented more often later than 12 h (P = .037), more often to the hub and were more often in cardiogenic shock (P = .02), or requiring rescue percutaneous coronary intervention after failed thrombolysis (P < .0001). Lower postprocedural Thrombolysis in Myocardial Infarction 3 flow (P = .029) and more thrombectomy (P = .046) were observed. SARS-CoV-2 was associated with a significantly higher in-hospital mortality (25.7 vs 7%, adjusted Odds Ratio (OR) [95% Confidence Interval] = 3.2 [1.71-5.99], P < .001) in-hospital definite in-stent thrombosis (6.4 vs 1.1%, adjusted Odds Ratio [95% CI] = 6.26 [2.41-16.25], P < .001) and 30-day mortality (34.4 vs 8.5%, adjusted Hazard Ratio [95% CI] = 2.16 [1.45-3.23], P < .001), confirming that SARS-CoV-2 positivity is associated with impaired reperfusion, with negative prognostic consequences.