Chan Kelvin, Conroy Abigail, Khosla Atulya, Rubens Muni, Saxena Anshul, Ramamoorthy Venkataraghavan, Roy Mukesh, Appunni Sandeep, Doke Mayur, Ahmed Md Ashfaq, Zhang Zhenwei, McGranaghan Peter, Chaparro Sandra, Jimenez Javier
Nova Southeastern University, Fort Lauderdale.
Miami Cancer Institute, Baptist Health South Florida.
Coron Artery Dis. 2024 Jan 1;35(1):38-43. doi: 10.1097/MCA.0000000000001293. Epub 2023 Oct 24.
Acute myocardial infarction (AMI) is one of the most lethal complications of COVID-19 hospitalization. In this study, we looked for the occurrence of AMI and its effects on hospital outcomes among COVID-19 patients.
Data from the 2020 California State Inpatient Database was used retrospectively. All COVID-19 hospitalizations with age ≥ 18 years were included in the analyses. Adverse hospital outcomes included in-hospital mortality, prolonged length of stay (LOS), vasopressor use, mechanical ventilation, and ICU admission. Prolonged LOS was defined as any hospital LOS ≥ 75th percentile. Multivariate logistic regression analyses were used to understand the strength of associations after adjusting for cofactors.
Our analysis had 94 114 COVID-19 hospitalizations, and 1548 (1.6%) had AMI. Mortality (43.2% vs. 10.8%, P < 0.001), prolonged LOS (39.9% vs. 28.2%, P < 0.001), vasopressor use (7.8% vs. 2.1%, P < 0.001), mechanical ventilation (35.0% vs. 9.7%, P < 0.001), and ICU admission (33.0% vs. 9.4%, P < 0.001) were significantly higher among COVID-19 hospitalizations with AMI. The odds of adverse outcomes such as mortality (aOR 3.90, 95% CI: 3.48-4.36), prolonged LOS (aOR 1.23, 95% CI: 1.10-1.37), vasopressor use (aOR 3.71, 95% CI: 3.30-4.17), mechanical ventilation (aOR 2.71, 95% CI: 2.21-3.32), and ICU admission (aOR 3.51, 95% CI: 3.12-3.96) were significantly more among COVID-19 hospitalizations with AMI.
Despite the very low prevalence of AMI among COVID-19 hospitalizations, the study showed a substantially greater risk of adverse hospital outcomes and mortality. COVID-19 patients with AMI should be aggressively treated to improve hospital outcomes.
急性心肌梗死（AMI）是COVID-19住院最致命的并发症之一。在本研究中，我们探寻了COVID-19患者中AMI的发生情况及其对住院结局的影响。
回顾性使用2020年加利福尼亚州住院患者数据库的数据。分析纳入所有年龄≥18岁的COVID-19住院患者。不良住院结局包括院内死亡、住院时间延长（LOS）、血管升压药使用、机械通气和入住重症监护病房（ICU）。住院时间延长定义为任何住院时间≥第75百分位数。多因素逻辑回归分析用于在调整协变量后了解关联强度。
我们的分析纳入了94114例COVID-19住院患者，其中1548例（1.6%）发生了AMI。AMI的COVID-19住院患者的死亡率（43.2%对10.8%，P<0.001）、住院时间延长（39.9%对28.2%，P<0.001）、血管升压药使用（7.8%对2.1%，P<0.001）、机械通气（35.0%对9.7%，P<0.001）和入住ICU（33.0%对9.4%，P<0.001）显著更高。AMI的COVID-19住院患者出现死亡（调整后比值比[aOR]3.90，95%置信区间[CI]：3.48-4.36）、住院时间延长（aOR 1.23，95%CI：1.10-1.37）、血管升压药使用（aOR 3.71，95%CI：3.30-4.17）、机械通气（aOR 2.71，95%CI：2.21-3.32）和入住ICU（aOR 3.51，95%CI：3.12-3.96）等不良结局的几率显著更高。
尽管COVID-19住院患者中AMI的患病率很低，但该研究表明不良住院结局和死亡率的风险显著更高。应积极治疗患有AMI的COVID-19患者以改善住院结局。
