Impact of SARS-CoV-2 positivity on clinical outcome among STEMI patients undergoing mechanical reperfusion : Insights from the ISACS STEMI COVID 19 registry

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De Luca , G , Debel , N , Cercek , M , Jensen , L O , Vavlukis , M , Calmac , L , Johnson , T , Rourai Ferrer , G , Ganyukov , V , Wojakowski , W , Kinnaird , T , von Birgelen , C , Cottin , Y , IJsselmuiden , A , Tuccillo , B , Versaci , F , Royaards , K-J , ten Berg , J , Laine , M , Dirksen , M , Siviglia , M , Casella , G , Kala , P , Gil , J L D , Banning , A , Becerra , V , De Simone , C , Santucci , A , Carrillo , X , Scoccia , A , Amoroso , G , van't Hof , A W , Kovarnik , T , Tsigkas , G , Mehilli , J , Gabrielli , G , Rios , X F , Bakraceski , N , Levesque , S , Cirrincione , G , Guiducci , V , Kidawa , M , Spedicato , L , Marinucci , L , Ludman , P , Zilio , F , Galasso , G , Fabris , E , Menichelli , M , Garcia-Touchard , A , Manzo , S , Caiazzo , G , Moreu , J , Fores , J S , Donazzan , L , Vignali , L , Teles , R , Benit , E , Agostoni , P , Ojeda , F B , Lehtola , H , Camacho-Freiere , S , Kraaijeveld , A , Antti , Y , Boccalatte , M , Deharo , P , Martinez-Luengas , I L , Scheller , B , Varytimiadi , E , Moreno , R , Uccello , G , Faurie , B , Barrios , A G , Milewski , M , Bruwiere , E , Smits , P , Wilbert , B , Di Uccio , F S , Parodi , G , Kedhi , E & Verdoia , M 2021 , ' Impact of SARS-CoV-2 positivity on clinical outcome among STEMI patients undergoing mechanical reperfusion : Insights from the ISACS STEMI COVID 19 registry ' , Atherosclerosis , vol. 332 , pp. 48-54 . https://doi.org/10.1016/j.atherosclerosis.2021.06.926

Title: Impact of SARS-CoV-2 positivity on clinical outcome among STEMI patients undergoing mechanical reperfusion : Insights from the ISACS STEMI COVID 19 registry
Author: De Luca, Giuseppe; Debel, Niels; Cercek, Miha; Jensen, Lisette Okkels; Vavlukis, Marija; Calmac, Lucian; Johnson, Tom; Rourai Ferrer, Gerard; Ganyukov, Vladimir; Wojakowski, Wojtek; Kinnaird, Tim; von Birgelen, Clemens; Cottin, Yves; IJsselmuiden, Alexander; Tuccillo, Bernardo; Versaci, Francesco; Royaards, Kees-Jan; ten Berg, Jurrien; Laine, Mika; Dirksen, Maurits; Siviglia, Massimo; Casella, Gianni; Kala, Petr; Gil, Jose Luis Diez; Banning, Adrian; Becerra, Victor; De Simone, Ciro; Santucci, Andrea; Carrillo, Xavier; Scoccia, Alessandra; Amoroso, Giovanni; van't Hof, Arnoud Wj; Kovarnik, Tomas; Tsigkas, Grigorios; Mehilli, Julinda; Gabrielli, Gabriele; Rios, Xacobe Flores; Bakraceski, Nikola; Levesque, Sebastien; Cirrincione, Giuseppe; Guiducci, Vincenzo; Kidawa, Michal; Spedicato, Leonardo; Marinucci, Lucia; Ludman, Peter; Zilio, Filippo; Galasso, Gennaro; Fabris, Enrico; Menichelli, Maurizio; Garcia-Touchard, Arturo; Manzo, Stephane; Caiazzo, Gianluca; Moreu, Jose; Fores, Juan Sanchis; Donazzan, Luca; Vignali, Luigi; Teles, Rui; Benit, Edouard; Agostoni, Pierfrancesco; Ojeda, Francisco Bosa; Lehtola, Heidi; Camacho-Freiere, Santiago; Kraaijeveld, Adriaan; Antti, Ylitalo; Boccalatte, Marco; Deharo, Pierre; Martinez-Luengas, Inigo Lozano; Scheller, Bruno; Varytimiadi, Efthymia; Moreno, Raul; Uccello, Giuseppe; Faurie, Benjamin; Barrios, Alejandro Gutierrez; Milewski, Marek; Bruwiere, Ewout; Smits, Pieter; Wilbert, Bor; Di Uccio, Fortunato Scotto; Parodi, Guido; Kedhi, Elvin; Verdoia, Monica
Other contributor: University of Helsinki, HUS Heart and Lung Center

Date: 2021-09
Language: eng
Number of pages: 7
Belongs to series: Atherosclerosis
ISSN: 0021-9150
DOI: https://doi.org/10.1016/j.atherosclerosis.2021.06.926
URI: http://hdl.handle.net/10138/335749
Abstract: Background and aims: SARS-Cov-2 predisposes patients to thrombotic complications, due to excessive inflam-mation, endothelial dysfunction, platelet activation, and coagulation/fibrinolysis disturbances. The aim of the present study was to evaluate clinical characteristics and prognostic impact of SARS-CoV-2 positivity among STEMI patients undergoing primary percutaneous coronary intervention (PPCI). Methods: We selected SARS-CoV-2 positive patients included in the ISACS-STEMI COVID-19, a retrospective multicenter European registry including 6609 STEMI patients treated with PPCI from March 1st until April 30th, in 2019 and 2020. As a reference group, we randomly sampled 5 SARS-Cov-2 negative patients per each SARS-CoV-2 positive patient, individually matched for age, sex, and hospital/geographic area. Study endpoints were in-hospital mortality, definite stent thrombosis, heart failure. Results: Our population is represented by 62 positive SARS-CoV-2 positive patients who were compared with a matched population of 310 STEMI patients. No significant difference was observed in baseline characteristics or the modality of access to the PCI center. In the SARS-CoV-2 positive patients, the culprit lesion was more often located in the RCA (p < 0.001). Despite similar pre and postprocedural TIMI flow, we observed a trend in higher use of GP IIb-IIIa inhibitors and a significantly higher use of thrombectomy in the SARS-CoV-2 positive patients. SARS-CoV-2 positivity was associated with a remarkably higher in hospital mortality (29% vs 5.5%, p < 0.001), definite in-stent thrombosis (8.1% vs 1.6%, p symbolscript 0.004) and heart failure (22.6% vs 10.6%, p symbolscript 0.001) that was confirmed after adjustment for confounding factors. Conclusions: Our study showed that among STEMI patients, SARS-CoV-2 positivity is associated with larger thrombus burden, a remarkably higher mortality but also higher rates of in-stent thrombosis and heart failure.
Subject: SARS-CoV-2
ST segment elevation myocardial infarction
Thrombosis(please add them)
ELEVATION MYOCARDIAL-INFARCTION
THROMBUS ASPIRATION
PRIMARY ANGIOPLASTY
METAANALYSIS
MORTALITY
3121 General medicine, internal medicine and other clinical medicine
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