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2019冠状病毒病对急性心肌梗死的影响:一项全国住院患者样本分析

Impact of COVID-19 on Acute Myocardial Infarction: A National Inpatient Sample Analysis.

作者信息

Nanavaty Dhairya, Sinha Rishav, Kaul Diksha, Sanghvi Ankushi, Kumar Vikash, Vachhani Bhavyakumar, Singh Sohrab, Devarakonda Pradeepkumar, Reddy Sarath, Verghese Dhiran

机构信息

Department of Internal Medicine, The Brooklyn Hospital Center, NY.

Department of Internal Medicine, The Brooklyn Hospital Center, NY.

出版信息

Curr Probl Cardiol. 2024 Jan;49(1 Pt A):102030. doi: 10.1016/j.cpcardiol.2023.102030. Epub 2023 Aug 11.

Abstract

COVID-19 has been associated with a higher incidence of acute myocardial infarction and related complications. We sought to assess the impact of COVID-19 diagnosis on hospitalizations with an index admission of AMI. The National inpatient sample 2020 was queried for hospitalizations with an index admission of AMI, further stratified for admissions with and without COVID-19. The 2 groups' mortality, procedure, and complication rates were compared using suitable statistical tests. Multivariate regression analysis was further performed to study the impact of COVID-19 on mortality as the primary outcome and length of stay and total hospital cost as secondary outcomes. A total of 555,540 admissions for AMI were identified, of which 5818 (1.04%) had concomitant COVID-19. Hospitalizations in the COVID-19 cohort of both groups had a lower procedure rate for coronary angiography. Thrombolysis use was higher in the STEMI patients with COVID-19. Most cardiac complications in AMI patients were higher when infected with SARS-CoV-2. Multivariate regression analysis revealed that COVID-19 led to higher odds of mortality and total length of stay in AMI hospitalizations. COVID-19 portends a worse prognosis in hospitalizations with AMI. These admissions have a significantly higher mortality rate and increased complications.

摘要

新冠病毒病(COVID-19)与急性心肌梗死及相关并发症的较高发病率有关。我们试图评估COVID-19诊断对以急性心肌梗死(AMI)为索引入院的住院治疗的影响。对2020年全国住院患者样本中以AMI为索引入院的患者进行查询,并进一步按是否感染COVID-19对入院患者进行分层。使用适当的统计检验比较两组的死亡率、手术率和并发症发生率。进一步进行多变量回归分析,以研究COVID-19对作为主要结局的死亡率以及作为次要结局的住院时间和总住院费用的影响。共确定了555540例AMI入院患者,其中5818例(1.04%)同时感染了COVID-19。两组中COVID-19队列的住院患者冠状动脉造影的手术率较低。COVID-19的ST段抬高型心肌梗死(STEMI)患者溶栓使用率较高。急性心肌梗死患者感染严重急性呼吸综合征冠状病毒2(SARS-CoV-2)时,大多数心脏并发症发生率更高。多变量回归分析显示,COVID-19导致AMI住院患者死亡率和总住院时间增加的几率更高。COVID-19预示着AMI住院患者的预后更差。这些入院患者的死亡率显著更高,并发症增加。

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