A b s t r a c t
Introduction: The coronavirus disease 2019 (COVID-19) infection has changed everyday clinical practice, with a shortage of solid
data about its implications for ST-elevation myocardial infarction (STEMI) patients.
Aim: To evaluate the impact of COVID-19 on 6-month clinical outcomes of patients with STEMI and determine the mortality
predictors after STEMI during the COVID-19 pandemic.
Material and methods: This prospective observational study was conducted on consecutive STEMI patients who presented to
our hospital between April and October 2021. A total of 74 COVID-19-positive patients were included in group I and compared to
148 COVID-19-negative patients (group II). We compared the two cohorts’ rates of major adverse cardiovascular events (MACEs;
composite of death from any cause, recurrent MI, target-vessel revascularization, and stroke) at 6 months.
Results: COVID-19 STEMI patients were more likely to present with angina equivalent symptoms, had higher Killip class at
admission, and higher levels of high-sensitive cardiac troponin T and serum C-reactive protein. The 6-month rates of MACEs were
significantly higher in STEMI patients with COVID-19 compared to non-COVID-19 patients (41.9% vs. 16.9%, respectively; p < 0.001)
and were mainly due to higher in-hospital mortality (20.3% vs. 6.1%, respectively; p = 0.001). The independent predictors of 6-month
mortality in STEMI patients during the COVID-19 pandemic were the absence of ST resolution, low systolic blood and higher Killip
class on admission, presence of severe MR and atrial fibrillation, and anterior wall STEMI.
Conclusions: STEMI patients with superimposed COVID-19 infection had worse clinical outcomes, with almost three times higher
in-hospital mortality and 6-month MACEs. |
