[Risk factors for in-hospital mortality in patients with acute myocardial infarction during the COVID-19 outbreak].

INTRODUCTION AND OBJECTIVES

Despite advances in treatment, patients with acute myocardial infarction (AMI) still exhibit unfavorable short- and long-term prognoses. In addition, there is scant evidence about the clinical outcomes of patients with AMI and coronavirus disease 2019 (COVID-19). The objective of this study was to describe the clinical presentation, complications, and risk factors for mortality in patients admitted for AMI during the COVID-19 pandemic.

METHODS

This prospective, multicenter, cohort study included all consecutive patients with AMI who underwent coronary angiography in a 30-day period corresponding chronologically with the COVID-19 outbreak (March 15 to April 15, 2020). Clinical presentations and outcomes were compared between COVID-19 and non-COVID-19 patients. The effect of COVID-19 on mortality was assessed by propensity score matching and with a multivariate logistic regression model.

RESULTS

In total, 187 patients were admitted for AMI, 111 with ST-segment elevation AMI and 76 with non-ST-segment elevation AMI. Of these, 32 (17%) were diagnosed with COVID-19. GRACE score, Killip-Kimball classification, and several inflammatory markers were significantly higher in COVID-19-positive patients. Total and cardiovascular mortality were also significantly higher in COVID-19-positive patients (25% vs 3.8% [ < .001] and 15.2% vs 1.8% [ = .001], respectively). GRACE score > 140 (OR, 23.45; 95%CI, 2.52-62.51;  = .005) and COVID-19 (OR, 6.61; 95%CI, 1.82-24.43;  = .02) were independent predictors of in-hospital death.

CONCLUSIONS

During this pandemic, a high GRACE score and COVID-19 were independent risk factors associated with higher in-hospital mortality.:www.revespcardiol.org/en.