SARS-CoV-2 Positivity, Stent Thrombosis, and 30-day Mortality in STEMI Patients Undergoing Mechanical Reperfusion

• Authors: DE LUCA Giuseppe; ALGOWHARY Magdy; UGUZ Berat; OLIVEIRA Dinaldo C; GANYUKOV Vladimir; ZIMBAKOV Zan; CERCEK Miha; JENSEN Lisette Okkels; LOH Poay Huan; CALMAC Lucian; FERRER Gerard Roura I; QUADROS Alexandre; MILEWSKI Marek; SCOTTO Di Uccio Fortunato; CLEMENS von Birgelen; VERSACI Francesco; JURRIEN Ten Berg; CASELLA Gianni; LUNG Aaron Wong Sung; KALA Petr; GIL Jose Luis Diez; CARRILLO Xavier; DIRKSEN Maurits; BECERRA-MUNOZ Victor M; LEE Michael Kang-Yin; JUZAR Dafsah Arifa; JOAQUIM Rodrigo de Moura; CIRO De Simone; MILICIC Davor; DAVLOUROS Periklis; BAKRACESKI Nikola; ZILIO Filippo; DONAZZAN Luca; KRAAIJEVELD Adriaan; GALASSO Gennaro; ARPAD Lux; MARINUCCI Lucia; GUIDUCCI Vincenzo; MENICHELLI Maurizio; SCOCCIA Alessandra; YAMAC Aylin Hatice; MERT Kadir Ugur; RIOS Xacobe Flores; KOVARNIK Tomas; KIDAWA Michal; MOREU Jose; FLAVIEN Vincent; FABRIS Enrico; MARTINEZ-LUENGAS Inigo Lozano; BOCCALATTE Marco; OJEDA Francisco Bosa; ARELLANO-SERRANO Carlos; CAIAZZO Gianluca; CIRRINCIONE Giuseppe; KAO Hsien-Li; FORES Juan Sanchis; VIGNALI Luigi; PEREIRA Helder; MANZO-SILBERMANN Stephane; ORDONEZ Santiago; OZKAN Alev Arat; SCHELLER Bruno; LEHTOLA Heidi; TELES Rui; MANTIS Christos; ANTTI Ylitalo; SILVEIRA Joao Antonio Brum; BESSONOV Ivan; ZONI Rodrigo; SAVONITTO Stefano; KOCHIADAKIS George; ALEXOPOULOS Dimitrios; URIBE Carlos E; KANAKAKIS John; FAURIE Benjamin; GABRIELLI Gabriele; BARRIOS Alejandro Gutierrez; BACHINI Juan Pablo; ROCHA Alex; TAM Frankie Chor-Cheung; RODRIGUEZ Alfredo; LUKITO Antonia Anna; BELLEMAIN-APPAIX Anne; PESSAH Gustavo; CORTESE Giuliana; PARODI Guido; BURGADHA Mohammed Abed; KEDHI Elvin; LAMELAS Pablo; SURYAPRANATA Harry; NARDIN Matteo; VERDOIA Monica
• Year of publication: 2023
• Type: Article in Periodical
• Magazine / Source: ANGIOLOGY
• MU Faculty or unit: Faculty of Medicine
• web: https://journals.sagepub.com/doi/10.1177/00033197221129351
• Doi: http://dx.doi.org/10.1177/00033197221129351
• Keywords: thrombosis; STEMI; outcome
• Description: SARS-Cov-2 has been suggested to promote thrombotic complications and higher mortality. The aim of the present study was to evaluate the impact of SARS-CoV-2 positivity on in-hospital outcome and 30-day mortality in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI) enrolled in the International Survey on Acute Coronary Syndromes ST-segment elevation Myocardial Infarction (ISACS-STEMI COVID-19 registry. The 109 SARS-CoV-2 positive patients were compared with 2005 SARS-CoV-2 negative patients. Positive patients were older (P = .002), less often active smokers (P = .002), and hypercholesterolemic (P = .006), they presented more often later than 12 h (P = .037), more often to the hub and were more often in cardiogenic shock (P = .02), or requiring rescue percutaneous coronary intervention after failed thrombolysis (P < .0001). Lower postprocedural Thrombolysis in Myocardial Infarction 3 flow (P = .029) and more thrombectomy (P = .046) were observed. SARS-CoV-2 was associated with a significantly higher in-hospital mortality (25.7 vs 7%, adjusted Odds Ratio (OR) [95% Confidence Interval] = 3.2 [1.71-5.99], P < .001) in-hospital definite in-stent thrombosis (6.4 vs 1.1%, adjusted Odds Ratio [95% CI] = 6.26 [2.41-16.25], P < .001) and 30-day mortality (34.4 vs 8.5%, adjusted Hazard Ratio [95% CI] = 2.16 [1.45-3.23], P < .001), confirming that SARS-CoV-2 positivity is associated with impaired reperfusion, with negative prognostic consequences.