Trends in Clinical Presentation, Management, and Outcomes of STEMI in Patients With COVID-19

Santiago Garcia; Payam Dehghani; Larissa Stanberry; Cindy Grines; Rajan A.G. Patel; Keshav R. Nayak; Avneet Singh; Wah Wah Htun; Ameer Kabour; Nima Ghasemzadeh; Cristina Sanina; Joseph Aragon; M. Chadi Alraies; Catherine Benziger; Brynn Okeson; Ross Garberich; Frederick G. Welt; Laura Davidson; Abdul Moiz Hafiz; Deepak Acharya; Jay Stone; Aditya Mehra; Shy Amlani; Ehtisham Mahmud; Jay Giri; Mehmet Yildiz; Timothy D. Henry

doi:10.1016/j.jacc.2022.03.345

Trends in Clinical Presentation, Management, and Outcomes of STEMI in Patients With COVID-19

Santiago Garcia^*, Payam Dehghani, Larissa Stanberry, Cindy Grines, Rajan A.G. Patel, Keshav R. Nayak, Avneet Singh, Wah Wah Htun, Ameer Kabour, Nima Ghasemzadeh, Cristina Sanina, Joseph Aragon, M. Chadi Alraies, Catherine Benziger, Brynn Okeson, Ross Garberich, Frederick G. Welt, Laura Davidson, Abdul Moiz Hafiz, Deepak AcharyaJay Stone, Aditya Mehra, Shy Amlani, Ehtisham Mahmud, Jay Giri, Mehmet Yildiz, Timothy D. Henry

^*Corresponding author for this work

Medicine, Cardiology Division

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

8 Scopus citations

Abstract

Background: We previously reported high in-hospital mortality for ST-segment elevation myocardial infarction (STEMI) patients with COVID-19 treated in the early phase of the pandemic. Objectives: The purpose of this study was to describe trends of COVID-19 patients with STEMI during the course of the pandemic. Methods: The NACMI (North American COVID-19 STEMI) registry is a prospective, investigator-initiated, multicenter, observational registry of hospitalized STEMI patients with confirmed or suspected COVID-19 infection in North America. We compared trends in clinical characteristics, management, and outcomes of patients treated in the first year of the pandemic (January 2020 to December 2020) vs those treated in the second year (January 2021 to December 2021). Results: A total of 586 COVID-19–positive patients with STEMI were included in the present analysis; 227 treated in Y2020 and 359 treated in Y2021. Patients’ characteristics changed over time. Relative to Y2020, the proportion of Caucasian patients was higher (58% vs 39%; P < 0.001), patients presented more frequently with typical ischemic symptoms (59% vs 51%; P = 0.04), and patients were less likely to have shock pre-PCI (13% vs 18%; P = 0.07) or pulmonary manifestations (33% vs. 47%; P = 0.001) in Y2021. In-hospital mortality decreased from 33% (Y2020) to 23% (Y2021) (P = 0.008). In Y2021, none of the 22 vaccinated patients expired in hospital, whereas in-hospital death was recorded in 37 (22%) unvaccinated patients (P = 0.009). Conclusions: Significant changes have occurred in the clinical characteristics and outcomes of STEMI patients with COVID-19 infection during the course of the pandemic.

Original language	English (US)
Pages (from-to)	2236-2244
Number of pages	9
Journal	Journal of the American College of Cardiology
Volume	79
Issue number	22
DOIs	https://doi.org/10.1016/j.jacc.2022.03.345
State	Published - Jun 7 2022

Keywords

COVID-19
STEMI
heart attack
outcomes

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.jacc.2022.03.345

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Garcia, S., Dehghani, P., Stanberry, L., Grines, C., Patel, R. A. G., Nayak, K. R., Singh, A., Htun, W. W., Kabour, A., Ghasemzadeh, N., Sanina, C., Aragon, J., Alraies, M. C., Benziger, C., Okeson, B., Garberich, R., Welt, F. G., Davidson, L., Hafiz, A. M., ... Henry, T. D. (2022). Trends in Clinical Presentation, Management, and Outcomes of STEMI in Patients With COVID-19. Journal of the American College of Cardiology, 79(22), 2236-2244. https://doi.org/10.1016/j.jacc.2022.03.345

@article{527c5f532d8a4d5fae17046d7d1778be,

title = "Trends in Clinical Presentation, Management, and Outcomes of STEMI in Patients With COVID-19",

abstract = "Background: We previously reported high in-hospital mortality for ST-segment elevation myocardial infarction (STEMI) patients with COVID-19 treated in the early phase of the pandemic. Objectives: The purpose of this study was to describe trends of COVID-19 patients with STEMI during the course of the pandemic. Methods: The NACMI (North American COVID-19 STEMI) registry is a prospective, investigator-initiated, multicenter, observational registry of hospitalized STEMI patients with confirmed or suspected COVID-19 infection in North America. We compared trends in clinical characteristics, management, and outcomes of patients treated in the first year of the pandemic (January 2020 to December 2020) vs those treated in the second year (January 2021 to December 2021). Results: A total of 586 COVID-19–positive patients with STEMI were included in the present analysis; 227 treated in Y2020 and 359 treated in Y2021. Patients{\textquoteright} characteristics changed over time. Relative to Y2020, the proportion of Caucasian patients was higher (58% vs 39%; P < 0.001), patients presented more frequently with typical ischemic symptoms (59% vs 51%; P = 0.04), and patients were less likely to have shock pre-PCI (13% vs 18%; P = 0.07) or pulmonary manifestations (33% vs. 47%; P = 0.001) in Y2021. In-hospital mortality decreased from 33% (Y2020) to 23% (Y2021) (P = 0.008). In Y2021, none of the 22 vaccinated patients expired in hospital, whereas in-hospital death was recorded in 37 (22%) unvaccinated patients (P = 0.009). Conclusions: Significant changes have occurred in the clinical characteristics and outcomes of STEMI patients with COVID-19 infection during the course of the pandemic.",

keywords = "COVID-19, STEMI, heart attack, outcomes",

author = "Santiago Garcia and Payam Dehghani and Larissa Stanberry and Cindy Grines and Patel, {Rajan A.G.} and Nayak, {Keshav R.} and Avneet Singh and Htun, {Wah Wah} and Ameer Kabour and Nima Ghasemzadeh and Cristina Sanina and Joseph Aragon and Alraies, {M. Chadi} and Catherine Benziger and Brynn Okeson and Ross Garberich and Welt, {Frederick G.} and Laura Davidson and Hafiz, {Abdul Moiz} and Deepak Acharya and Jay Stone and Aditya Mehra and Shy Amlani and Ehtisham Mahmud and Jay Giri and Mehmet Yildiz and Henry, {Timothy D.}",

note = "Funding Information: This work Is supported by the American College of Cardiology Accreditation Grant and Saskatchewan Health Research Foundation (SHRF). The NACMI (North American COVID-19 STEMI) registry received financial support from Medtronic and Abbott Vascular. Dr Garcia has received institutional research grants from Edwards Lifesciences, BSCI, Medtronic, and Abbott Vascular; has served as a consultant for the American College of Cardiology, Medtronic, and BSCI; and has served as a proctor for Edwards Lifesciences. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. Funding Information: The authors thank the administrative and scientific personnel of the Society for Cardiovascular Angiography and Interventions, Minneapolis Heart Institute Foundation, Kiahltone R. Thao, and Logan Van Hon for their contributions to the NACMI registry. Publisher Copyright: {\textcopyright} 2022 American College of Cardiology Foundation",

year = "2022",

month = jun,

day = "7",

doi = "10.1016/j.jacc.2022.03.345",

language = "English (US)",

volume = "79",

pages = "2236--2244",

journal = "Journal of the American College of Cardiology",

issn = "0735-1097",

publisher = "Elsevier USA",

number = "22",

}

Garcia, S, Dehghani, P, Stanberry, L, Grines, C, Patel, RAG, Nayak, KR, Singh, A, Htun, WW, Kabour, A, Ghasemzadeh, N, Sanina, C, Aragon, J, Alraies, MC, Benziger, C, Okeson, B, Garberich, R, Welt, FG, Davidson, L, Hafiz, AM, Acharya, D, Stone, J, Mehra, A, Amlani, S, Mahmud, E, Giri, J, Yildiz, M & Henry, TD 2022, 'Trends in Clinical Presentation, Management, and Outcomes of STEMI in Patients With COVID-19', Journal of the American College of Cardiology, vol. 79, no. 22, pp. 2236-2244. https://doi.org/10.1016/j.jacc.2022.03.345

TY - JOUR

T1 - Trends in Clinical Presentation, Management, and Outcomes of STEMI in Patients With COVID-19

AU - Garcia, Santiago

AU - Dehghani, Payam

AU - Stanberry, Larissa

AU - Grines, Cindy

AU - Patel, Rajan A.G.

AU - Nayak, Keshav R.

AU - Singh, Avneet

AU - Htun, Wah Wah

AU - Kabour, Ameer

AU - Ghasemzadeh, Nima

AU - Sanina, Cristina

AU - Aragon, Joseph

AU - Alraies, M. Chadi

AU - Benziger, Catherine

AU - Okeson, Brynn

AU - Garberich, Ross

AU - Welt, Frederick G.

AU - Davidson, Laura

AU - Hafiz, Abdul Moiz

AU - Acharya, Deepak

AU - Stone, Jay

AU - Mehra, Aditya

AU - Amlani, Shy

AU - Mahmud, Ehtisham

AU - Giri, Jay

AU - Yildiz, Mehmet

AU - Henry, Timothy D.

N1 - Funding Information: This work Is supported by the American College of Cardiology Accreditation Grant and Saskatchewan Health Research Foundation (SHRF). The NACMI (North American COVID-19 STEMI) registry received financial support from Medtronic and Abbott Vascular. Dr Garcia has received institutional research grants from Edwards Lifesciences, BSCI, Medtronic, and Abbott Vascular; has served as a consultant for the American College of Cardiology, Medtronic, and BSCI; and has served as a proctor for Edwards Lifesciences. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. Funding Information: The authors thank the administrative and scientific personnel of the Society for Cardiovascular Angiography and Interventions, Minneapolis Heart Institute Foundation, Kiahltone R. Thao, and Logan Van Hon for their contributions to the NACMI registry. Publisher Copyright: © 2022 American College of Cardiology Foundation

PY - 2022/6/7

Y1 - 2022/6/7

N2 - Background: We previously reported high in-hospital mortality for ST-segment elevation myocardial infarction (STEMI) patients with COVID-19 treated in the early phase of the pandemic. Objectives: The purpose of this study was to describe trends of COVID-19 patients with STEMI during the course of the pandemic. Methods: The NACMI (North American COVID-19 STEMI) registry is a prospective, investigator-initiated, multicenter, observational registry of hospitalized STEMI patients with confirmed or suspected COVID-19 infection in North America. We compared trends in clinical characteristics, management, and outcomes of patients treated in the first year of the pandemic (January 2020 to December 2020) vs those treated in the second year (January 2021 to December 2021). Results: A total of 586 COVID-19–positive patients with STEMI were included in the present analysis; 227 treated in Y2020 and 359 treated in Y2021. Patients’ characteristics changed over time. Relative to Y2020, the proportion of Caucasian patients was higher (58% vs 39%; P < 0.001), patients presented more frequently with typical ischemic symptoms (59% vs 51%; P = 0.04), and patients were less likely to have shock pre-PCI (13% vs 18%; P = 0.07) or pulmonary manifestations (33% vs. 47%; P = 0.001) in Y2021. In-hospital mortality decreased from 33% (Y2020) to 23% (Y2021) (P = 0.008). In Y2021, none of the 22 vaccinated patients expired in hospital, whereas in-hospital death was recorded in 37 (22%) unvaccinated patients (P = 0.009). Conclusions: Significant changes have occurred in the clinical characteristics and outcomes of STEMI patients with COVID-19 infection during the course of the pandemic.

AB - Background: We previously reported high in-hospital mortality for ST-segment elevation myocardial infarction (STEMI) patients with COVID-19 treated in the early phase of the pandemic. Objectives: The purpose of this study was to describe trends of COVID-19 patients with STEMI during the course of the pandemic. Methods: The NACMI (North American COVID-19 STEMI) registry is a prospective, investigator-initiated, multicenter, observational registry of hospitalized STEMI patients with confirmed or suspected COVID-19 infection in North America. We compared trends in clinical characteristics, management, and outcomes of patients treated in the first year of the pandemic (January 2020 to December 2020) vs those treated in the second year (January 2021 to December 2021). Results: A total of 586 COVID-19–positive patients with STEMI were included in the present analysis; 227 treated in Y2020 and 359 treated in Y2021. Patients’ characteristics changed over time. Relative to Y2020, the proportion of Caucasian patients was higher (58% vs 39%; P < 0.001), patients presented more frequently with typical ischemic symptoms (59% vs 51%; P = 0.04), and patients were less likely to have shock pre-PCI (13% vs 18%; P = 0.07) or pulmonary manifestations (33% vs. 47%; P = 0.001) in Y2021. In-hospital mortality decreased from 33% (Y2020) to 23% (Y2021) (P = 0.008). In Y2021, none of the 22 vaccinated patients expired in hospital, whereas in-hospital death was recorded in 37 (22%) unvaccinated patients (P = 0.009). Conclusions: Significant changes have occurred in the clinical characteristics and outcomes of STEMI patients with COVID-19 infection during the course of the pandemic.

KW - COVID-19

KW - STEMI

KW - heart attack

KW - outcomes

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JO - Journal of the American College of Cardiology

JF - Journal of the American College of Cardiology

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ER -

Trends in Clinical Presentation, Management, and Outcomes of STEMI in Patients With COVID-19

Abstract

Keywords

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UN SDGs

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