Institut del Cor, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.
EuroIntervention. 2021 Apr 20;16(17):1426-1433. doi: 10.4244/EIJ-D-20-00935.
The aim of this study was to assess clinical and prognosis differences in patients with COVID-19 and STEMI.
Using a nationwide registry of consecutive patients managed within 42 specific STEMI care networks, we compared patient and procedure characteristics and in-hospital outcomes in two different cohorts, according to whether or not they had COVID-19. Among 1,010 consecutive STEMI patients, 91 were identified as having COVID-19 (9.0%). With the exception of smoking status (more frequent in non-COVID-19 patients) and previous coronary artery disease (more frequent in COVID-19 patients), clinical characteristics were similar between the groups, but COVID-19 patients had more heart failure on arrival (31.9% vs 18.4%, p=0.002). Mechanical thrombectomy (44% vs 33.5%, p=0.046) and GP IIb/IIIa inhibitor administration (20.9% vs 11.2%, p=0.007) were more frequent in COVID-19 patients, who had an increased in-hospital mortality (23.1% vs 5.7%, p<0.0001), that remained consistent after adjustment for age, sex, Killip class and ischaemic time (OR 4.85, 95% CI: 2.04-11.51; p<0.001). COVID-19 patients had an increase of stent thrombosis (3.3% vs 0.8%, p=0.020) and cardiogenic shock development after PCI (9.9% vs 3.8%, p=0.007).
Our study revealed a significant increase in in-hospital mortality, stent thrombosis and cardiogenic shock development after PCI in patients with STEMI and COVID-19 in comparison with contemporaneous non-COVID-19 STEMI patients.
本研究旨在评估 COVID-19 和 STEMI 患者的临床和预后差异。
我们使用全国范围内连续患者管理的 42 个特定 STEMI 护理网络的注册中心，根据他们是否患有 COVID-19，比较了两个不同队列患者和程序特征以及住院期间的结局。在连续的 1010 例 STEMI 患者中，有 91 例被确定为患有 COVID-19（9.0%）。除了吸烟状况（在非 COVID-19 患者中更为常见）和先前的冠状动脉疾病（在 COVID-19 患者中更为常见）外，两组的临床特征相似，但 COVID-19 患者入院时心力衰竭更为常见（31.9%比 18.4%，p=0.002）。机械血栓切除术（44%比 33.5%，p=0.046）和 GP IIb/IIIa 抑制剂的应用（20.9%比 11.2%，p=0.007）在 COVID-19 患者中更为常见，这些患者的住院死亡率更高（23.1%比 5.7%，p<0.0001），在调整年龄、性别、Killip 分级和缺血时间后仍然一致（OR 4.85，95%CI：2.04-11.51；p<0.001）。COVID-19 患者支架血栓形成（3.3%比 0.8%，p=0.020）和 PCI 后心源性休克的发展（9.9%比 3.8%，p=0.007）增加。
与同期非 COVID-19 STEMI 患者相比，本研究显示 STEMI 合并 COVID-19 患者住院期间死亡率、支架血栓形成和 PCI 后心源性休克的发生率显著增加。
