González-Pacheco Héctor, Gopar-Nieto Rodrigo, Manzur-Sandoval Daniel, Ayala-Navarrete Marco A, Eid-Lidt Guering, Briseño-De-la-Cruz José L, Altamirano-Castillo Alfredo, Mendoza-García Salvador, Araiza-Garaygordobil Diego, Sierra-Lara-Martínez Daniel, Arias-Mendoza Alexandra
Coronary Care Unit, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico.
Department of Interventional Cardiology. Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico.
Arch Cardiol Mex. 2023 Sep 5;93(Supl 6):10-15. doi: 10.24875/ACM.21000327.
The objective of the study is to identify clinical and angiographic characteristics of patients with ST-segment elevation myocardial infarction (STEMI) but without clinical manifestations of COVID-19 infection during the pandemic, compared with patients 1 year before the pandemic.
Observational study that included 138 consecutive patients hospitalized with STEMI who underwent primary percutaneous coronary intervention (PCI) without COVID-19 infection during the 2020 pandemic. A group of 175 STEMI patients treated with PCI in the year before the pandemic served as the control group.
During the periods analyzed, compared with the control group, patients admitted during the pandemic without clinical manifestations of COVID-19 did not have significant differences in demographic characteristics, comorbidities, or delayed time and location of the acute myocardial infarction. Furthermore, there were no differences between the two groups concerning levels of CK-MB and NT-proBNP, or in inflammation markers and left ventricular ejection fraction. In patients without COVID-19 during the pandemic compared with control, we found a higher intracoronary thrombus burden (thrombus grade 5; 78.3% vs. 62.9%, respectively. p = 0.002). Accordingly, the use of glycoprotein IIB/IIIa inhibitors (37.7% vs. 26.3%, p = 0.03) was higher in these patients.
This study demonstrates an increased thrombus burden in STEMI patients without clinical manifestation of COVID-19 during the pandemic compared with the same time period in the previous year.
本研究的目的是确定在疫情期间患有ST段抬高型心肌梗死（STEMI）但无COVID-19感染临床表现的患者的临床和血管造影特征，并与疫情前1年的患者进行比较。
一项观察性研究，纳入了2020年疫情期间138例因STEMI住院并接受了直接经皮冠状动脉介入治疗（PCI）且无COVID-19感染的连续患者。一组175例在疫情前一年接受PCI治疗的STEMI患者作为对照组。
在分析的时间段内，与对照组相比，疫情期间入院且无COVID-19临床表现的患者在人口统计学特征、合并症、急性心肌梗死的延迟时间和部位方面没有显著差异。此外，两组在肌酸激酶同工酶（CK-MB）和N末端脑钠肽前体（NT-proBNP）水平、炎症标志物和左心室射血分数方面也没有差异。与对照组相比，疫情期间无COVID-19的患者冠状动脉内血栓负荷更高（血栓分级5级；分别为78.3%和62.9%。p = 0.002）。因此，这些患者中糖蛋白IIb/IIIa抑制剂的使用比例更高（37.7%对26.3%，p = 0.03）。
本研究表明，与上一年同期相比，疫情期间无COVID-19临床表现的STEMI患者血栓负荷增加。
