tetano
Editor, Senior Moderator
Catheter Cardiovasc Interv
. 2021 Apr 27.
doi: 10.1002/ccd.29709. Online ahead of print.
Patients with COVID-19 who experience a myocardial infarction have complex coronary morphology and high in-hospital mortality: Primary results of a nationwide angiographic study
Alexandre Abizaid[SUP] 1 2 3 [/SUP], Carlos M Campos[SUP] 1 4 [/SUP], Patr?cia O Guimar?es[SUP] 1 [/SUP], Jos? de Ribamar Costa Jr[SUP] 3 5 [/SUP], Breno A A Falc?o[SUP] 6 [/SUP], Fernanda Mangione[SUP] 7 [/SUP], Adriano Caixeta[SUP] 8 [/SUP], Pedro A Lemos[SUP] 9 [/SUP], Fabio S de Brito Jr[SUP] 1 2 10 [/SUP], Ricardo Cavalcante[SUP] 10 [/SUP], Cristiano Guedes Bezerra[SUP] 11 [/SUP], Leandro Cortes[SUP] 12 [/SUP], Henrique B Ribeiro[SUP] 13 [/SUP], Francis R de Souza[SUP] 1 [/SUP], Natassja Huemer[SUP] 1 [/SUP], Renata M do Val[SUP] 1 [/SUP], Bruno Caramelli[SUP] 1 [/SUP], Daniela Calderaro[SUP] 1 [/SUP], Felipe G Lima[SUP] 1 [/SUP], Ludhmila A Hajjar[SUP] 1 [/SUP], Roxana Mehran[SUP] 14 [/SUP], Roberto Kalil Filho[SUP] 1 2 [/SUP], COVID MI investigators
Affiliations
Abstract
Objectives: We aimed to explore angiographic patterns and in-hospital outcomes of patients with concomitant coronavirus disease-19 (COVID-19) and myocardial infarction (MI).
Background: Patients with COVID-19 may experience MI during the course of the viral infection. However, this association is currently poorly understood.
Methods: This is a multicenter prospective study of consecutive patients with concomitant COVID-19 and MI who underwent coronary angiography. Quantitative and qualitative coronary angiography were analyzed by two observers in an independent core lab.
Results: A total of 152 patients were included, of whom 142 (93.4%) had COVID-19 diagnosis confirmation. The median time between symptom onset and hospital admission was 5 (1-10) days. A total of 83 (54.6%) patients presented with ST-elevation MI. The median angiographic Syntax score was 16 (9.0-25.3) and 69.0% had multi-vessel disease. At least one complex lesion was found in 73.0% of patients, 51.3% had a thrombus containing lesion, and 57.9% had myocardial blush grades 0/1. The overall in-hospital mortality was 23.7%. ST-segment elevation MI presentation and baseline myocardial blush grades 0 or 1 were independently associated with a higher risk of death (HR 2.75, 95%CI 1.30-5.80 and HR 3.73, 95%CI 1.61-8.61, respectively).
Conclusions: Patients who have a MI in the context of ongoing COVID-19 mostly present complex coronary morphologies, implying a background of prior atherosclerotic disease superimposed on a thrombotic milieu. The in-hospital prognosis is poor with a markedly high mortality, prompting further investigation to better clarify this newly described condition.
Keywords: coronary angiography; coronavirus disease 2019; myocardial infarction.
. 2021 Apr 27.
doi: 10.1002/ccd.29709. Online ahead of print.
Patients with COVID-19 who experience a myocardial infarction have complex coronary morphology and high in-hospital mortality: Primary results of a nationwide angiographic study
Alexandre Abizaid[SUP] 1 2 3 [/SUP], Carlos M Campos[SUP] 1 4 [/SUP], Patr?cia O Guimar?es[SUP] 1 [/SUP], Jos? de Ribamar Costa Jr[SUP] 3 5 [/SUP], Breno A A Falc?o[SUP] 6 [/SUP], Fernanda Mangione[SUP] 7 [/SUP], Adriano Caixeta[SUP] 8 [/SUP], Pedro A Lemos[SUP] 9 [/SUP], Fabio S de Brito Jr[SUP] 1 2 10 [/SUP], Ricardo Cavalcante[SUP] 10 [/SUP], Cristiano Guedes Bezerra[SUP] 11 [/SUP], Leandro Cortes[SUP] 12 [/SUP], Henrique B Ribeiro[SUP] 13 [/SUP], Francis R de Souza[SUP] 1 [/SUP], Natassja Huemer[SUP] 1 [/SUP], Renata M do Val[SUP] 1 [/SUP], Bruno Caramelli[SUP] 1 [/SUP], Daniela Calderaro[SUP] 1 [/SUP], Felipe G Lima[SUP] 1 [/SUP], Ludhmila A Hajjar[SUP] 1 [/SUP], Roxana Mehran[SUP] 14 [/SUP], Roberto Kalil Filho[SUP] 1 2 [/SUP], COVID MI investigators
Affiliations
- PMID: 33904638
- DOI: 10.1002/ccd.29709
Abstract
Objectives: We aimed to explore angiographic patterns and in-hospital outcomes of patients with concomitant coronavirus disease-19 (COVID-19) and myocardial infarction (MI).
Background: Patients with COVID-19 may experience MI during the course of the viral infection. However, this association is currently poorly understood.
Methods: This is a multicenter prospective study of consecutive patients with concomitant COVID-19 and MI who underwent coronary angiography. Quantitative and qualitative coronary angiography were analyzed by two observers in an independent core lab.
Results: A total of 152 patients were included, of whom 142 (93.4%) had COVID-19 diagnosis confirmation. The median time between symptom onset and hospital admission was 5 (1-10) days. A total of 83 (54.6%) patients presented with ST-elevation MI. The median angiographic Syntax score was 16 (9.0-25.3) and 69.0% had multi-vessel disease. At least one complex lesion was found in 73.0% of patients, 51.3% had a thrombus containing lesion, and 57.9% had myocardial blush grades 0/1. The overall in-hospital mortality was 23.7%. ST-segment elevation MI presentation and baseline myocardial blush grades 0 or 1 were independently associated with a higher risk of death (HR 2.75, 95%CI 1.30-5.80 and HR 3.73, 95%CI 1.61-8.61, respectively).
Conclusions: Patients who have a MI in the context of ongoing COVID-19 mostly present complex coronary morphologies, implying a background of prior atherosclerotic disease superimposed on a thrombotic milieu. The in-hospital prognosis is poor with a markedly high mortality, prompting further investigation to better clarify this newly described condition.
Keywords: coronary angiography; coronavirus disease 2019; myocardial infarction.