Impact of SARS-CoV-2 positivity on clinical outcome among STEMI patients undergoing mechanical reperfusion: Insights from the ISACS STEMI COVID 19 registry

Giuseppe De Luca; Niels Debel; Miha Cercek; Lisette Okkels Jensen; Marija Vavlukis; Lucian Calmac; Tom Johnson; Gerard Rourai Ferrer; Vladimir Ganyukov; Wojtek Wojakowski; Tim Kinnaird; Clemens von Birgelen; Yves Cottin; Alexander IJsselmuiden; Bernardo Tuccillo; Francesco Versaci; Kees-Jan Royaards; Jurrien ten Berg; Mika Laine; Maurits Dirksen; Massimo Siviglia; Gianni Casella; Petr Kala; Jose Luis Diez Gil; Adrian Banning; Victor Becerra; Ciro De Simone; Andrea Santucci; Xavier Carrillo; Alessandra Scoccia; Giovanni Amoroso; Arnoud Wj van't Hof; Tomas Kovarnik; Grigorios Tsigkas; Julinda Mehilli; Gabriele Gabrielli; Xacobe Flores Rios; Nikola Bakraceski; Sebastien Levesque; Giuseppe Cirrincione; Vincenzo Guiducci; Michal Kidawa; Leonardo Spedicato; Lucia Marinucci; Peter Ludman; Filippo Zilio; Gennaro Galasso; Enrico Fabris; Maurizio Menichelli; Arturo Garcia-Touchard; Stephane Manzo; Gianluca Caiazzo; Jose Moreu; Juan Sanchis Fores; Luca Donazzan; Luigi Vignali; Rui Teles; Edouard Benit; Pierfrancesco Agostoni; Francisco Bosa Ojeda; Heidi Lehtola; Santiago Camacho-Freiere; Adriaan Kraaijeveld; Ylitalo Antti; Marco Boccalatte; Pierre Deharo; Inigo Lozano Martinez-Luengas; Bruno Scheller; Efthymia Varytimiadi; Raul Moreno; Giuseppe Uccello; Benjamin Faurie; Alejandro Gutierrez Barrios; Marek Milewski; Ewout Bruwiere; Pieter Smits; Bor Wilbert; Fortunato Scotto Di Uccio; Guido Parodi; Elvin Kedhi; Monica Verdoia

doi:10.1016/j.atherosclerosis.2021.06.926

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Impact of SARS-CoV-2 positivity on clinical outcome among STEMI patients undergoing mechanical reperfusion: Insights from the ISACS STEMI COVID 19 registry

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Impact of SARS-CoV-2 positivity on clinical outcome among STEMI patients undergoing mechanical reperfusion: Insights from the ISACS STEMI COVID 19 registry

Giuseppe De Luca, Niels Debel, Miha Cercek, Lisette Okkels Jensen, Marija Vavlukis, Lucian Calmac, Tom Johnson, Gerard Rourai Ferrer, Vladimir Ganyukov, Wojtek Wojakowski, …

Atherosclerosis, Vol.332, pp.48-54

09/01/2021

DOI: 10.1016/j.atherosclerosis.2021.06.926

PMCID: PMC8294603

PMID: 34391035

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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.

Cardiac & Cardiovascular Systems

Cardiovascular System & Cardiology

Life Sciences & Biomedicine

Peripheral Vascular Disease

Science & Technology

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Title: Subtitle: Impact of SARS-CoV-2 positivity on clinical outcome among STEMI patients undergoing mechanical reperfusion: Insights from the ISACS STEMI COVID 19 registry
Creators: Giuseppe De Luca - Azienda Ospedaliero Universitaria Maggiore della Carita
Niels Debel - KU Leuven
Miha Cercek - Ljubljana University Medical Centre
Lisette Okkels Jensen - Odense University Hospital
Marija Vavlukis - Saints Cyril and Methodius University of Skopje
Lucian Calmac - Clinical Emergency Hospital Bucharest
Tom Johnson - University Hospitals Bristol NHS Foundation Trust
Gerard Rourai Ferrer - Hosp Univ Bellvitge, Heart Dis Inst, Intervent Cardiol Unit, Barcelona, Spain
Vladimir Ganyukov - Kemerovo State University
Wojtek Wojakowski - Medical University of Silesia
Tim Kinnaird - University Hospital of Wales
Clemens von Birgelen - Medisch Spectrum Twente
Yves Cottin - Maison des Sciences de l’Homme de Dijon
Alexander IJsselmuiden - Amphia Ziekenhuis
Bernardo Tuccillo - Osped Mare, Div Cardiol, Naples, Italy
Francesco Versaci - Ospedale Santa Maria Goretti
Kees-Jan Royaards - Maasstad Ziekenhuis
Jurrien ten Berg - St Antonius Hosp, Div Cardiol, Nieuwegein, Netherlands
Mika Laine - Helsinki University Hospital
Maurits Dirksen - Northwest Hospital
Massimo Siviglia - Azienda Ospedaliero Universitaria Ospedali Riuniti
Gianni Casella - Ospedale Maggiore
Petr Kala - Masaryk University
Jose Luis Diez Gil - Hospital Universitari i Politècnic La Fe
Adrian Banning - John Radcliffe Hospital
Victor Becerra - Hospital Clínico Universitario Virgen de la Victoria
Ciro De Simone - Clin Villa dei Fiori, Div Cardiol, Acerra, Italy
Andrea Santucci - Ospedale Santa Maria
Xavier Carrillo - Hospital Universitari Germans Trias i Pujol
Alessandra Scoccia - Ospedale Sant'Anna
Giovanni Amoroso - OLVG
Arnoud Wj van't Hof - Mastricht Univ Med Ctr, Maastricht, Netherlands
Tomas Kovarnik - General University Hospital in Prague
Grigorios Tsigkas - General University Hospital of Patras
Julinda Mehilli - Ludwig-Maximilians-Universität München
Gabriele Gabrielli - Azienda Ospedaliero Universitaria Ospedali Riuniti
Xacobe Flores Rios - Complexo Hospitalario Universitario A Coruña
Nikola Bakraceski - Ctr Cardiovasc Dis, Ohrid, North Macedonia
Sebastien Levesque - Centre Hospitalier Universitaire de Poitiers
Giuseppe Cirrincione - Azienda di Rilievo Nazionale ed Alta Specializzazione
Vincenzo Guiducci - Azienda Sanitaria Unità Locale di Reggio Emilia
Michal Kidawa - Med Univ Lodz, Cent Hosp, Lodz, Poland
Leonardo Spedicato - Ospedale Santa Maria della Misericordia di Udine
Lucia Marinucci - Ospedali Riuniti Marche Nord
Peter Ludman - NIHR Surgical Reconstruction and Microbiology Research Centre
Filippo Zilio - Ospedale Santa Chiara
Gennaro Galasso - Ospedali Riuniti San Giovanni di Dio e Ruggi d'Aragona
Enrico Fabris - Azienda Ospedaliero Universitaria Ospedali Riuniti
Maurizio Menichelli - Medical University of Silesia
Arturo Garcia-Touchard - Hosp Puerta de Hierro Majadahonda, Div Cardiol, Madrid, Spain
Stephane Manzo - Inserm
Gianluca Caiazzo - Azienda Ospedaliera S.Giuseppe Moscati
Jose Moreu - Complejo Hospitalario Universitario de Toledo
Juan Sanchis Fores - Hospital Clínico Universitario de Valencia
Luca Donazzan - Ospedale di Bolzano
Luigi Vignali - Azienda Osped Sanitaria, Intervent Cardiol Unit, Parma, Italy
Rui Teles - Hospital de Santa Cruz
Edouard Benit - Jessa Hospital
Pierfrancesco Agostoni - Ziekenhuisnetwerk Antwerpen Stuivenberg
Francisco Bosa Ojeda - Hospital Universitario de Canarias
Heidi Lehtola - Oulu University Hospital
Santiago Camacho-Freiere - Hospital Juan Ramón Jiménez
Adriaan Kraaijeveld - University Medical Center Utrecht
Ylitalo Antti - Turku PET Centre
Marco Boccalatte - Ospedale Santa Maria
Pierre Deharo - Hôpital de la Timone
Inigo Lozano Martinez-Luengas - Hospital de Cabueñes
Bruno Scheller - Saarland University
Efthymia Varytimiadi - University General Hospital Attikon
Raul Moreno - Hospital Universitario La Paz
Giuseppe Uccello - Alessandro Manzoni Hospital
Benjamin Faurie - Groupe Hospitalier Mutualiste de Grenoble
Alejandro Gutierrez Barrios - Hospital Universitario Puerta del Mar
Marek Milewski - Osped F Spaziani, Div Cardiol, Frosinone, Italy
Ewout Bruwiere - Jessa Hospital
Pieter Smits - Maasstad Ziekenhuis
Bor Wilbert - St Antonius Hosp, Div Cardiol, Nieuwegein, Netherlands
Fortunato Scotto Di Uccio - Osped Mare, Div Cardiol, Naples, Italy
Guido Parodi - Azienda Ospedaliero Universitaria di Sassari
Elvin Kedhi - Université Libre de Bruxelles
Monica Verdoia - Ospedale degli Infermi
Resource Type: Journal article
Publication Details: Atherosclerosis, Vol.332, pp.48-54
Publisher: Elsevier
DOI: 10.1016/j.atherosclerosis.2021.06.926
PMID: 34391035
PMCID: PMC8294603
ISSN: 0021-9150
eISSN: 1879-1484
Number of pages: 7
Language: English
Date published: 09/01/2021
Academic Unit: Electrical and Computer Engineering
Record Identifier: 9984627314602771

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