Markson F E, Akuna E, Lim C Y, Khemani L, Amanullah A
Department of Medicine, New York City Health and Hospitals/Lincoln, New York, NY, USA.
Department of Medicine, Division of Cardiology, Einstein Medical Center/Thomas Jefferson University, Philadelphia, PA, USA.
Am Heart J Plus. 2023 Aug;32:100305. doi: 10.1016/j.ahjo.2023.100305. Epub 2023 Jun 12.
BACKGROUND/STUDY OBJECTIVE: The effect of the COVID-19 pandemic affected health care delivery, as it led to variable outcomes in different disease states including cardiovascular diseases. In this study, we evaluated the impact of coexisting COVID-19 on Acute Myocardial Infarction (AMI).
DESIGN/SETTING: We analyzed discharge records of AMI patients from the National Inpatient Sample (NIS) in the year 2020.
Using propensity score matching, we assessed the impact of COVID-19 infection on the in-hospital outcomes of patients presenting with AMI.
There were 1154 patients with concomitant COVID-19 infection and AMI who were matched with 109,990 patients with AMI and without COVID-19. We found that patients with COVID-19 who had AMI were less likely to have dyslipidemia (64.6 % vs. 70.4 %, < 0.001), peripheral vascular disease (2.4 % vs. 3.8 % = 0.0017), smoking history (23.5 % vs. 28.2 % < 0.0001) and hypertension (37.1 % vs. 40.1 % = 0.004).COVID-19 was associated with higher hospital mortality rates (Adjusted odds ratio aOR: 2.72, CI: 2.23-3.30, < 0.001), cardiac arrest (aOR: 1.65, 95 % CI: 1.26-2.15, p < 0.001), cardiogenic shock (aOR:1.36,95 % CI: 1.10-1.68, = 0.004) and respiratory failure (aOR:1.81, 95 % CI: 1.55-2.11 < 0.001) compared to AMI patients without COVID-19. There was also a significant association between coexisting COVID-19 and longer duration of hospital stay (Adjusted mean differences:1.40, 95 % CI: 1.31-1.59 < 0.0001) in AMI patients.
COVID-19 infection is associated with worse in-hospital mortality and cardiorespiratory complications in patients with AMI.
背景/研究目的：2019冠状病毒病（COVID-19）大流行的影响波及医疗服务，导致包括心血管疾病在内的不同疾病状态出现了不同的结果。在本研究中，我们评估了合并COVID-19对急性心肌梗死（AMI）的影响。
设计/研究地点：我们分析了2020年全国住院患者样本（NIS）中AMI患者的出院记录。
我们采用倾向评分匹配法，评估了COVID-19感染对AMI患者住院结局的影响。
1154例合并COVID-19感染和AMI的患者与109,990例患有AMI但未感染COVID-19的患者进行了匹配。我们发现，合并COVID-19的AMI患者患血脂异常的可能性较小（64.6%对70.4%，<0.001）、外周血管疾病（2.4%对3.8%，=0.0017）、有吸烟史（23.5%对28.2%，<0.0001）和高血压（37.1%对40.1%，=0.004）。与未感染COVID-19的AMI患者相比，COVID-19与更高的医院死亡率（调整优势比aOR：2.72，可信区间CI：2.23 - 3.30，<0.001）、心脏骤停（aOR：1.65，95%CI：1.26 - 2.15，p<0.001）、心源性休克（aOR：1.36，95%CI：1.10 - 1.68，=0.004）和呼吸衰竭（aOR：1.81，95%CI：1.55 - 2.11，<0.001）相关。合并COVID-19与AMI患者更长的住院时间之间也存在显著关联（调整后平均差异：1.40，95%CI：1.31 - 1.59，<0.0001）。
COVID-19感染与AMI患者更差的住院死亡率和心肺并发症相关。
