Mechanical Circulatory Support in Patients With COVID-19 Presenting With Myocardial Infarction

Raviteja R. Guddeti; Cristina Sanina; Rajiv Jauhar; Timothy D. Henry; Payam Dehghani; Ross Garberich; Christian W. Schmidt; Keshav R. Nayak; Jay S. Shavadia; Akshay Bagai; Chadi Alraies; Aditya Mehra; Rodrigo Bagur; Cindy Grines; Avneet Singh; Rajan A.G. Patel; Wah Wah Htun; Nima Ghasemzadeh; Laura Davidson; Deepak Acharya; Ameer Kabour; Abdul Moiz Hafiz; Shy Amlani; Hal S. Wasserman; Timothy Smith; Navin K. Kapur; Santiago Garcia

doi:10.1016/j.amjcard.2022.09.030

Mechanical Circulatory Support in Patients With COVID-19 Presenting With Myocardial Infarction

Raviteja R. Guddeti, Cristina Sanina, Rajiv Jauhar, Timothy D. Henry, Payam Dehghani, Ross Garberich, Christian W. Schmidt, Keshav R. Nayak, Jay S. Shavadia, Akshay Bagai, Chadi Alraies, Aditya Mehra, Rodrigo Bagur, Cindy Grines, Avneet Singh, Rajan A.G. Patel, Wah Wah Htun, Nima Ghasemzadeh, Laura Davidson, Deepak AcharyaAmeer Kabour, Abdul Moiz Hafiz, Shy Amlani, Hal S. Wasserman, Timothy Smith, Navin K. Kapur, Santiago Garcia^*

^*Corresponding author for this work

Medicine, Cardiology Division

Research output: Contribution to journal › Article › peer-review

1 Scopus citations

Abstract

ST-segment elevation myocardial infarction (STEMI) complicating COVID-19 is associated with an increased risk of cardiogenic shock and mortality. However, little is known about the frequency of use and clinical impact of mechanical circulatory support (MCS) in these patients. We sought to define patterns of MCS utilization, patient characteristics, and outcomes in patients with COVID-19 with STEMI. The NACMI (North American COVID-19 Myocardial Infarction) is an ongoing prospective, observational registry of patients with COVID-19 positive (COVID-19+) with STEMI with a contemporary control group of persons under investigation who subsequently tested negative for COVID-19 (COVID-19−). We compared the baseline characteristics and in-hospital outcomes of COVID-19+ and patients with COVID-19− according to the use of MCS. The primary outcome was a composite of in-hospital mortality, stroke, recurrent MI, and repeat unplanned revascularization. A total of 1,379 patients (586 COVID-19+ and 793 COVID-19−) enrolled in the NACMI registry between January 2020 and November 2021 were included in this analysis; overall, MCS use was 12.3% (12.1% [n = 71] COVID-19+/MCS positive [MCS+] vs 12.4% [n = 98] COVID-19−/MCS+). Baseline characteristics were similar between the 2 groups. The use of percutaneous coronary intervention was similar between the groups (84% vs 78%; p = 0.404). Intra-aortic balloon pump was the most frequently used MCS device in both groups (53% in COVID-19+/MCS+ and 75% in COVID-19−/MCS+). The primary outcome was significantly higher in COVID-19+/MCS+ patients (60% vs 30%; p = 0.001) because of very high in-hospital mortality (59% vs 28%; p = 0.001). In conclusion, patients with COVID-19+ with STEMI requiring MCS have very high in-hospital mortality, likely related to the significantly higher pulmonary involvement compared with patients with COVID-19− with STEMI requiring MCS.

Original language	English (US)
Pages (from-to)	76-83
Number of pages	8
Journal	American Journal of Cardiology
Volume	187
DOIs	https://doi.org/10.1016/j.amjcard.2022.09.030
State	Published - Jan 15 2023

Funding

This work was supported by the Society for Cardiovascular Angiography and Interventions (Washington, District of Columbia), American College of Cardiology Accreditation Grant (Washington, District of Columbia), Canadian Association of Interventional Cardiology (Ottawa, Ontario, Canada), Medtronic (Dublin, Ireland), and Abbott Vascular (Chicago, Illinois).

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.amjcard.2022.09.030

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Guddeti, R. R., Sanina, C., Jauhar, R., Henry, T. D., Dehghani, P., Garberich, R., Schmidt, C. W., Nayak, K. R., Shavadia, J. S., Bagai, A., Alraies, C., Mehra, A., Bagur, R., Grines, C., Singh, A., Patel, R. A. G., Htun, W. W., Ghasemzadeh, N., Davidson, L., ... Garcia, S. (2023). Mechanical Circulatory Support in Patients With COVID-19 Presenting With Myocardial Infarction. American Journal of Cardiology, 187, 76-83. https://doi.org/10.1016/j.amjcard.2022.09.030

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title = "Mechanical Circulatory Support in Patients With COVID-19 Presenting With Myocardial Infarction",

abstract = "ST-segment elevation myocardial infarction (STEMI) complicating COVID-19 is associated with an increased risk of cardiogenic shock and mortality. However, little is known about the frequency of use and clinical impact of mechanical circulatory support (MCS) in these patients. We sought to define patterns of MCS utilization, patient characteristics, and outcomes in patients with COVID-19 with STEMI. The NACMI (North American COVID-19 Myocardial Infarction) is an ongoing prospective, observational registry of patients with COVID-19 positive (COVID-19+) with STEMI with a contemporary control group of persons under investigation who subsequently tested negative for COVID-19 (COVID-19−). We compared the baseline characteristics and in-hospital outcomes of COVID-19+ and patients with COVID-19− according to the use of MCS. The primary outcome was a composite of in-hospital mortality, stroke, recurrent MI, and repeat unplanned revascularization. A total of 1,379 patients (586 COVID-19+ and 793 COVID-19−) enrolled in the NACMI registry between January 2020 and November 2021 were included in this analysis; overall, MCS use was 12.3% (12.1% [n = 71] COVID-19+/MCS positive [MCS+] vs 12.4% [n = 98] COVID-19−/MCS+). Baseline characteristics were similar between the 2 groups. The use of percutaneous coronary intervention was similar between the groups (84% vs 78%; p = 0.404). Intra-aortic balloon pump was the most frequently used MCS device in both groups (53% in COVID-19+/MCS+ and 75% in COVID-19−/MCS+). The primary outcome was significantly higher in COVID-19+/MCS+ patients (60% vs 30%; p = 0.001) because of very high in-hospital mortality (59% vs 28%; p = 0.001). In conclusion, patients with COVID-19+ with STEMI requiring MCS have very high in-hospital mortality, likely related to the significantly higher pulmonary involvement compared with patients with COVID-19− with STEMI requiring MCS.",

author = "Guddeti, {Raviteja R.} and Cristina Sanina and Rajiv Jauhar and Henry, {Timothy D.} and Payam Dehghani and Ross Garberich and Schmidt, {Christian W.} and Nayak, {Keshav R.} and Shavadia, {Jay S.} and Akshay Bagai and Chadi Alraies and Aditya Mehra and Rodrigo Bagur and Cindy Grines and Avneet Singh and Patel, {Rajan A.G.} and Htun, {Wah Wah} and Nima Ghasemzadeh and Laura Davidson and Deepak Acharya and Ameer Kabour and Hafiz, {Abdul Moiz} and Shy Amlani and Wasserman, {Hal S.} and Timothy Smith and Kapur, {Navin K.} and Santiago Garcia",

note = "Publisher Copyright: {\textcopyright} 2022 Elsevier Inc.",

year = "2023",

month = jan,

day = "15",

doi = "10.1016/j.amjcard.2022.09.030",

language = "English (US)",

volume = "187",

pages = "76--83",

journal = "American Journal of Cardiology",

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Guddeti, RR, Sanina, C, Jauhar, R, Henry, TD, Dehghani, P, Garberich, R, Schmidt, CW, Nayak, KR, Shavadia, JS, Bagai, A, Alraies, C, Mehra, A, Bagur, R, Grines, C, Singh, A, Patel, RAG, Htun, WW, Ghasemzadeh, N, Davidson, L, Acharya, D, Kabour, A, Hafiz, AM, Amlani, S, Wasserman, HS, Smith, T, Kapur, NK & Garcia, S 2023, 'Mechanical Circulatory Support in Patients With COVID-19 Presenting With Myocardial Infarction', American Journal of Cardiology, vol. 187, pp. 76-83. https://doi.org/10.1016/j.amjcard.2022.09.030

TY - JOUR

T1 - Mechanical Circulatory Support in Patients With COVID-19 Presenting With Myocardial Infarction

AU - Guddeti, Raviteja R.

AU - Sanina, Cristina

AU - Jauhar, Rajiv

AU - Henry, Timothy D.

AU - Dehghani, Payam

AU - Garberich, Ross

AU - Schmidt, Christian W.

AU - Nayak, Keshav R.

AU - Shavadia, Jay S.

AU - Bagai, Akshay

AU - Alraies, Chadi

AU - Mehra, Aditya

AU - Bagur, Rodrigo

AU - Grines, Cindy

AU - Singh, Avneet

AU - Patel, Rajan A.G.

AU - Htun, Wah Wah

AU - Ghasemzadeh, Nima

AU - Davidson, Laura

AU - Acharya, Deepak

AU - Kabour, Ameer

AU - Hafiz, Abdul Moiz

AU - Amlani, Shy

AU - Wasserman, Hal S.

AU - Smith, Timothy

AU - Kapur, Navin K.

AU - Garcia, Santiago

PY - 2023/1/15

Y1 - 2023/1/15

N2 - ST-segment elevation myocardial infarction (STEMI) complicating COVID-19 is associated with an increased risk of cardiogenic shock and mortality. However, little is known about the frequency of use and clinical impact of mechanical circulatory support (MCS) in these patients. We sought to define patterns of MCS utilization, patient characteristics, and outcomes in patients with COVID-19 with STEMI. The NACMI (North American COVID-19 Myocardial Infarction) is an ongoing prospective, observational registry of patients with COVID-19 positive (COVID-19+) with STEMI with a contemporary control group of persons under investigation who subsequently tested negative for COVID-19 (COVID-19−). We compared the baseline characteristics and in-hospital outcomes of COVID-19+ and patients with COVID-19− according to the use of MCS. The primary outcome was a composite of in-hospital mortality, stroke, recurrent MI, and repeat unplanned revascularization. A total of 1,379 patients (586 COVID-19+ and 793 COVID-19−) enrolled in the NACMI registry between January 2020 and November 2021 were included in this analysis; overall, MCS use was 12.3% (12.1% [n = 71] COVID-19+/MCS positive [MCS+] vs 12.4% [n = 98] COVID-19−/MCS+). Baseline characteristics were similar between the 2 groups. The use of percutaneous coronary intervention was similar between the groups (84% vs 78%; p = 0.404). Intra-aortic balloon pump was the most frequently used MCS device in both groups (53% in COVID-19+/MCS+ and 75% in COVID-19−/MCS+). The primary outcome was significantly higher in COVID-19+/MCS+ patients (60% vs 30%; p = 0.001) because of very high in-hospital mortality (59% vs 28%; p = 0.001). In conclusion, patients with COVID-19+ with STEMI requiring MCS have very high in-hospital mortality, likely related to the significantly higher pulmonary involvement compared with patients with COVID-19− with STEMI requiring MCS.

AB - ST-segment elevation myocardial infarction (STEMI) complicating COVID-19 is associated with an increased risk of cardiogenic shock and mortality. However, little is known about the frequency of use and clinical impact of mechanical circulatory support (MCS) in these patients. We sought to define patterns of MCS utilization, patient characteristics, and outcomes in patients with COVID-19 with STEMI. The NACMI (North American COVID-19 Myocardial Infarction) is an ongoing prospective, observational registry of patients with COVID-19 positive (COVID-19+) with STEMI with a contemporary control group of persons under investigation who subsequently tested negative for COVID-19 (COVID-19−). We compared the baseline characteristics and in-hospital outcomes of COVID-19+ and patients with COVID-19− according to the use of MCS. The primary outcome was a composite of in-hospital mortality, stroke, recurrent MI, and repeat unplanned revascularization. A total of 1,379 patients (586 COVID-19+ and 793 COVID-19−) enrolled in the NACMI registry between January 2020 and November 2021 were included in this analysis; overall, MCS use was 12.3% (12.1% [n = 71] COVID-19+/MCS positive [MCS+] vs 12.4% [n = 98] COVID-19−/MCS+). Baseline characteristics were similar between the 2 groups. The use of percutaneous coronary intervention was similar between the groups (84% vs 78%; p = 0.404). Intra-aortic balloon pump was the most frequently used MCS device in both groups (53% in COVID-19+/MCS+ and 75% in COVID-19−/MCS+). The primary outcome was significantly higher in COVID-19+/MCS+ patients (60% vs 30%; p = 0.001) because of very high in-hospital mortality (59% vs 28%; p = 0.001). In conclusion, patients with COVID-19+ with STEMI requiring MCS have very high in-hospital mortality, likely related to the significantly higher pulmonary involvement compared with patients with COVID-19− with STEMI requiring MCS.

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SN - 0002-9149

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JO - American Journal of Cardiology

JF - American Journal of Cardiology

ER -

Mechanical Circulatory Support in Patients With COVID-19 Presenting With Myocardial Infarction

Abstract

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UN SDGs

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