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http://hdl.handle.net/1942/36169
Title: | Impact of SARS-CoV-2 positivity on clinical outcome among STEMI patients undergoing mechanical reperfusion: Insights from the ISACS STEMI COVID 19 registry | Authors: | 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 |
Issue Date: | 2021 | Publisher: | ELSEVIER IRELAND LTD | Source: | ATHEROSCLEROSIS, 332 , p. 48 -54 | 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. | Notes: | De Luca, G (corresponding author), Eastern Piedmont Univ, Novara, Italy. giuseppe.deluca@med.uniupo.it |
Keywords: | SARS-CoV-2; ST segment elevation myocardial infarction;;Thrombosis(please add them) | Document URI: | http://hdl.handle.net/1942/36169 | ISSN: | 0021-9150 | e-ISSN: | 1879-1484 | DOI: | 10.1016/j.atherosclerosis.2021.06.926 | ISI #: | WOS:000693328700006 | Category: | A1 | Type: | Journal Contribution |
Appears in Collections: | Research publications |
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PIIS0021915021012156.pdf | Published version | 911.73 kB | Adobe PDF | View/Open |
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