Tweet
Rev Esp Cardiol
. 2020 Sep 17.
doi: 10.1016/j.recesp.2020.07.023. Online ahead of print.
[Risk factors for in-hospital mortality in patients with acute myocardial infarction during the COVID-19 outbreak]
[Article in Spanish]
Jorge Solano-L?pez 1 , Jos? Luis Zamorano 1 2 , Ana Pardo Sanz 1 , Ignacio Amat-Santos 2 3 , Fernando Sarnago 2 4 , Enrique Guti?rrez Iba?es 2 5 , Juan Sanchis 2 6 , Juan Ram?n Rey Blas 2 7 , Joan Antoni G?mez-Hospital 2 8 , Sandra Santos Mart?nez 3 , Nicol?s Manuel Maneiro-Mel?n 4 , Roberto Mateos Gait?n 5 , Jessika Gonz?lez D'Gregorio 6 , Luisa Salido 1 2 , Jos? L Mestre 1 , Marcelo Sanmart?n 1 2 , ?ngel S?nchez-Recalde 1 2
Affiliations
- PMID: 32963419
- PMCID: PMC7498230
- DOI: 10.1016/j.recesp.2020.07.023
Abstract
in English, Spanish
Introduction and objectives Despite advances in treatment, patients with acute myocardial infarction (AMI) still exhibit unfavorable short- and long-term prognoses. In addition, there is scant evidence about the clinical outcomes of patients with AMI and coronavirus disease 2019 (COVID-19). The objective of this study was to describe the clinical presentation, complications, and risk factors for mortality in patients admitted for AMI during the COVID-19 pandemic.Methods This prospective, multicenter, cohort study included all consecutive patients with AMI who underwent coronary angiography in a 30-day period corresponding chronologically with the COVID-19 outbreak (March 15 to April 15, 2020). Clinical presentations and outcomes were compared between COVID-19 and non-COVID-19 patients. The effect of COVID-19 on mortality was assessed by propensity score matching and with a multivariate logistic regression model.Results In total, 187 patients were admitted for AMI, 111 with ST-segment elevation AMI and 76 with non-ST-segment elevation AMI. Of these, 32 (17%) were diagnosed with COVID-19. GRACE score, Killip-Kimball classification, and several inflammatory markers were significantly higher in COVID-19-positive patients. Total and cardiovascular mortality were also significantly higher in COVID-19-positive patients (25% vs 3.8% [P < .001] and 15.2% vs 1.8% [P = .001], respectively). GRACE score > 140 (OR, 23.45; 95%CI, 2.52-62.51; P = .005) and COVID-19 (OR, 6.61; 95%CI, 1.82-24.43; P = .02) were independent predictors of in-hospital death.Conclusions During this pandemic, a high GRACE score and COVID-19 were independent risk factors associated with higher in-hospital mortality.
Keywords: AMI, acute myocardial infarction; ARDS, acute respiratory distress syndrome; Acute coronary syndrome; COVID-19; COVID-19, coronavirus disease 2019; Mortality; Myocardial infarction; NSTEMI, non-ST-segment elevation myocardial infarction; PCI, percutaneous coronary intervention; STEMIST, -segment elevation myocardial infarction.