Clin Cardiol . The impact of COVID-19 on clinical outcomes among acute myocardial infarction patients undergoing early invasive treatment strategy

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Clin Cardiol


. 2022 Aug 30.
doi: 10.1002/clc.23908. Online ahead of print.
The impact of COVID-19 on clinical outcomes among acute myocardial infarction patients undergoing early invasive treatment strategy


Prerna Sharma ¹ , Kajal Shah ² , Johanna Loomba ³ , Arti Patel ³ , Indika Mallawaarachchi ⁴ , Olivia Blazek ^{2 5} , Sarah Ratcliffe ⁴ , Khadijah Breathett ⁶ , Amber E Johnson ⁷ , Angela M Taylor ¹ , Michael Salerno ¹ , Michael Ragosta ¹ , Nishtha Sodhi ¹ , Daniel Addison ⁸ , Selma Mohammed ⁹ , Kenneth C Bilchick ¹ , Sula Mazimba ¹



Affiliations

• PMID: 36040721
• DOI: 10.1002/clc.23908

Abstract

Background: The implications of coronavirus disease 2019 (COVID-19) infection on outcomes after invasive therapeutic strategies among patients presenting with acute myocardial infarction (AMI) are not well studied.
Hypothesis: To assess the outcomes of COVID-19 patients presenting with AMI undergoing an early invasive treatment strategy.
Methods: This study was a cross-sectional, retrospective analysis of the National COVID Cohort Collaborative database including all patients presenting with a recorded diagnosis of AMI (ST-elevation myocardial infarction (MI) and non-ST elevation MI). COVID-19 positive patients with AMI were stratified into one of four groups: (1a) patients who had a coronary angiogram with percutaneous coronary intervention (PCI) within 3 days of their AMI; (1b) PCI within 3 days of AMI with coronary artery bypass graft (CABG) within 30 days; (2a) coronary angiogram without PCI and without CABG within 30 days; and (2b) coronary angiogram with CABG within 30 days. The main outcomes were respiratory failure, cardiogenic shock, prolonged length of stay, rehospitalization, and death.
Results: There were 10 506 COVID-19 positive patients with a diagnosis of AMI. COVID-19 positive patients with PCI had 8.2 times higher odds of respiratory failure than COVID-19 negative patients (p = .001). The odds of prolonged length of stay were 1.7 times higher in COVID-19 patients who underwent PCI (p = .024) and 1.9 times higher in patients who underwent coronary angiogram followed by CABG (p = .001).
Conclusion: These data demonstrate that COVID-19 positive patients with AMI undergoing early invasive coronary angiography had worse outcomes than COVID-19 negative patients.

Keywords: COVID-19; cardiac catheterization; pediatric clinical cardiology; percutaneous coronary intervention.