严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染对急性心肌梗死预后的影响。
The Influence of SARS-CoV-2 Infection on Acute Myocardial Infarction Outcomes.
作者信息
Hrycek Eugeniusz, Walawska-Hrycek Anna, Hamankiewicz Maciej, Milewski Krzysztof, Nowakowski Przemysław, Buszman Piotr, Żurakowski Aleksander
机构信息
American Heart of Poland, Topolowa 16, 32-500 Chrzanów, Poland.
Department of Cardiology, Faculty of Medical Sciences, Andrzej Frycz Modrzewski Kraków University, 30-705 Kraków, Poland.
出版信息
J Clin Med. 2023 Sep 11;12(18):5899. doi: 10.3390/jcm12185899.
BACKGROUND
This multicenter retrospective study with a control group was designed to assess the influence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on the outcomes of patients with myocardial infarction (MI).
METHODS
A total of 129 patients with COVID-19 who were treated for MI were included in this study. The control group comprised 129 comparable patients without SARS-CoV-2 infection. The in-hospital, out-of-hospital, and overall mortality were analyzed.
RESULTS
A total of thirty-one (24%) patients died in the study group, and two (1.6%) patients died in the control group (OR = 20.09; CI: 4.69-85.97; < 0.001). Similar results were observed in all analyzed patient subgroups. Multivariable Cox regression analysis confirmed the significant influence of SARS-CoV-2 infection on in-hospital outcomes (HR: 8.48459; CI: 1.982-36.320; = 0.004). Subanalysis of the groups with COVID-19 plus ST-elevation MI (STEMI) or non-ST-elevation MI (NSTEMI) revealed comparable mortality rates: 14 (21.12%) patients in the NSTEMI group and 17 (26.98%) patients in the STEMI subgroup died (OR: 1.3; CI: 0.56-3.37; = 0.45). During out-of-hospital observation, no differences in mortality were observed (OR: 0.77; CI: 0.11-4.07; = 0.73).
CONCLUSIONS
SARS-CoV-2 infection affects the in-hospital outcomes of patients with both MI and COVID-19, regardless of MI type (STEMI vs. NSTEMI).
背景
本项设有对照组的多中心回顾性研究旨在评估严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染对心肌梗死（MI）患者预后的影响。
方法
本研究纳入了129例因心肌梗死接受治疗的COVID-19患者。对照组包括129例无SARS-CoV-2感染的可比患者。分析了院内、院外及总体死亡率。
结果
研究组共有31例（24%）患者死亡，对照组有2例（1.6%）患者死亡（比值比=20.09；可信区间：4.69-85.97；P<0.001）。在所有分析的患者亚组中均观察到类似结果。多变量Cox回归分析证实SARS-CoV-2感染对院内结局有显著影响（风险比：8.48459；可信区间：1.982-36.320；P=0.004）。对COVID-19合并ST段抬高型心肌梗死（STEMI）或非ST段抬高型心肌梗死（NSTEMI）的亚组分析显示死亡率相当：NSTEMI组14例（21.12%）患者死亡，STEMI亚组17例（26.98%）患者死亡（比值比：1.3；可信区间：0.56-3.37；P=0.45）。在院外观察期间，未观察到死亡率差异（比值比：0.77；可信区间：0.11-4.07；P=0.73）。
结论
SARS-CoV-2感染会影响心肌梗死合并COVID-19患者的院内结局，无论心肌梗死类型（STEMI与NSTEMI）如何。
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