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
N1 - Funding Information:
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).
Publisher Copyright:
© 2022 Elsevier Inc.
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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U2 - 10.1016/j.amjcard.2022.09.030
DO - 10.1016/j.amjcard.2022.09.030
M3 - Article
C2 - 36459751
AN - SCOPUS:85141777026
SN - 0002-9149
VL - 187
SP - 76
EP - 83
JO - American Journal of Cardiology
JF - American Journal of Cardiology
ER -