Assessment Of COVID-19 Positive Patients With ST-Segment Elevation Myocardial Infarction During The COVID-19 Pandemic
Öz
Objective: The global impact of the coronavirus disease 2019 (COVID-19) pandemic has been shown to adversely affect the cardiovascular system. Investigating the clinical course of patients with ST-segment elevation myocardial infarction (STEMI) associated with COVID-19 infection is crucial to elucidate the mechanisms linking COVID-19 and STEMI. Assessing these patients from both cardiovascular and infection control perspectives is essential for improving clinical outcomes and reducing the burden on healthcare systems. This study aims to provide a comprehensive evaluation of the clinical course of COVID-19-positive STEMI patients.
Methods: This single-center, cross-sectional study analyzed 80 STEMI patients who underwent coronary angiography, comprising 38 COVID-19-positive individuals and 42 COVID-19-negative individuals. We assessed admission times, biochemical parameters, door-to-balloon times, angiographic data, length of hospital stay, and in-hospital mortality.
Results: The mean age in the COVID-19-positive group was 56.6±10.8 years, whereas that in the COVID-19-negative group was 53.6±10.8 years (P = .238). No significant differences in demographic characteristics were observed between the groups. However, C-reactive protein (CRP), white blood cell (WBC), and baseline troponin levels were significantly greater in the COVID-19-positive group (P < .001, P = .005, and P = .037, respectively). Echocardiographic evaluation revealed a lower ejection fraction (EF) in COVID-19-positive patients than in COVID-19-negative patients (P = .023). Angiographic evaluation revealed a greater thrombus burden and longer pain-to-balloon time in the COVID-19-positive group (P = .001 and P < .001, respectively). The length of hospital stay was also longer in the COVID-19-positive group (P < .001).
Conclusion: The findings of increased thrombus burden, prolonged pain-to-balloon time, and extended hospital stays among COVID-19-positive patients underscore the adverse cardiovascular effects of COVID-19. Delayed hospital presentation of patients with cardiovascular symptoms during the pandemic poses a challenge for timely diagnosis and management of critical cardiovascular conditions.
Anahtar Kelimeler
Etik Beyan
Etik İzin alınmıştır
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Kaynakça
- Driggin E, Madhavan MV, Bikdeli B, et al. Cardiovascular considerations for patients, health care workers, and health systems during the COVID-19 pandemic. J Am Coll Cardiol. 2020;75(18):2352–2371.
- Del Prete A, Conway F, Della Rocca DG, et al. COVID-19, acute myocardial injury, and infarction. Card Electrophysiol Clin. 2022;14(1):29–39.
- Ghasemzadeh N, Kim N, Amlani S, et al. A review of ST-elevation myocardial infarction in patients with COVID-19. Cardiol Clin. 2022;40(3):321–328.
- Wańha W, Wybraniec M, Kapłon-Cieślicka A, et al. Myocardial infarction in the shadow of COVID-19. Cardiol J. 2020;27(5):478–480.
- Thygesen K, Alpert JS, Jaffe AS, et al. Fourth universal definition of myocardial infarction. Glob Heart. 2018;13(4):305–338.
- Sianos G, Papafaklis MI, Daemen J, et al. Angiographic stent thrombosis after routine use of drug-eluting stents in STEMI: the importance of thrombus burden. J Am Coll Cardiol. 2007;50(7):573–583.
- Sabatine MS, Braunwald E. Thrombolysis In Myocardial Infarction (TIMI) Study Group: JACC Focus Seminar 2/8. J Am Coll Cardiol. 2021;77(22):2822–2845.
- Tufan A, Avanoğlu Güler A, Matucci-Cerinic M. COVID-19, immune system response, hyperinflammation and repurposing antirheumatic drugs. Turk J Med Sci. 2020;50(SI-1):620–632.
- Fajgenbaum DC, June CH. Cytokine storm. N Engl J Med. 2020;383(23):2255–2273.
- Shi S, Qin M, Shen B, et al. Association of cardiac injury with mortality in hospitalized patients with COVID-19 in Wuhan, China. JAMA Cardiol. 2020;5(7):802–810.
- Soy M, Keser G, Atagündüz P, et al. Cytokine storm in COVID-19: pathogenesis and overview of anti-inflammatory agents. Clin Rheumatol. 2020;39(7):2085–2094.
- Baran Akpınar F, Tuncer M, Dayan A. Factors associated with admission to the intensive care unit in hospitalized COVID-19 patients. Turk J Fam Pract. 2020;26(3):124–130.
- Oncul M, Karakurt C, Elkiran O, et al. Evaluation of frequency, follow-up and treatment of multisystem inflammatory syndrome related to COVID-19. Ann Med Res. 2022;29(11):1238–1245.
- Madjid M, Safavi-Naeini P, Solomon SD, Vardeny O. Potential effects of coronaviruses on the cardiovascular system: a review. JAMA Cardiol. 2020;5(7):831–840.
- Gharibzadeh A, Shahsanaei F, Rahimi PN. Clinical and cardiovascular characteristics of patients suffering STEMI after COVID-19: a systematic review and meta-analysis. Curr Probl Cardiol. 2023;48(1):101045.
- Chung MK, Zidar DA, Bristow MR, et al. COVID-19 and cardiovascular disease: from bench to bedside. Circ Res. 2021;128(8):1214–1236.
- Siripanthong B, Nazarian S, Muser D, et al. Recognizing COVID-19-related myocarditis: pathophysiology and guideline for diagnosis and management. Heart Rhythm. 2020;17(9):1463–1471.
- Aktaş H, Yildirim O, Gül M, İnci S. Comparison of AMI patients undergoing coronary angiography during the COVID-19 pandemic and the pre-pandemic period. MN Cardiol. 2021;27(4):199.
- Koc H, Barutcu G, Duman H. Case report of STEMI due to early-stage multiple stent thrombosis accompanied by COVID-19. Rize Med J. 2023;1(4):20–25.
- Bikdeli B, Madhavan MV, Jimenez D, et al. COVID-19 and thrombotic or thromboembolic disease: implications for therapy and follow-up. J Am Coll Cardiol. 2020;75(23):2950–2973.
- Choudry FA, Hamshere SM, Rathod KS, et al. High thrombus burden in COVID-19 patients with STEMI. J Am Coll Cardiol. 2020;76(10):1168–1176.
- Ferhatbegovic L, Pojskic B. Characteristics of acute coronary syndrome during COVID-19 pandemic. Atherosclerosis. 2023;379:90.
- Welt FGP, Shah PB, Aronow HD, et al. Catheterization laboratory considerations during the COVID-19 pandemic. J Am Coll Cardiol. 2020;75(18):2372–235.
Öz
Kaynakça
- Driggin E, Madhavan MV, Bikdeli B, et al. Cardiovascular considerations for patients, health care workers, and health systems during the COVID-19 pandemic. J Am Coll Cardiol. 2020;75(18):2352–2371.
- Del Prete A, Conway F, Della Rocca DG, et al. COVID-19, acute myocardial injury, and infarction. Card Electrophysiol Clin. 2022;14(1):29–39.
- Ghasemzadeh N, Kim N, Amlani S, et al. A review of ST-elevation myocardial infarction in patients with COVID-19. Cardiol Clin. 2022;40(3):321–328.
- Wańha W, Wybraniec M, Kapłon-Cieślicka A, et al. Myocardial infarction in the shadow of COVID-19. Cardiol J. 2020;27(5):478–480.
- Thygesen K, Alpert JS, Jaffe AS, et al. Fourth universal definition of myocardial infarction. Glob Heart. 2018;13(4):305–338.
- Sianos G, Papafaklis MI, Daemen J, et al. Angiographic stent thrombosis after routine use of drug-eluting stents in STEMI: the importance of thrombus burden. J Am Coll Cardiol. 2007;50(7):573–583.
- Sabatine MS, Braunwald E. Thrombolysis In Myocardial Infarction (TIMI) Study Group: JACC Focus Seminar 2/8. J Am Coll Cardiol. 2021;77(22):2822–2845.
- Tufan A, Avanoğlu Güler A, Matucci-Cerinic M. COVID-19, immune system response, hyperinflammation and repurposing antirheumatic drugs. Turk J Med Sci. 2020;50(SI-1):620–632.
- Fajgenbaum DC, June CH. Cytokine storm. N Engl J Med. 2020;383(23):2255–2273.
- Shi S, Qin M, Shen B, et al. Association of cardiac injury with mortality in hospitalized patients with COVID-19 in Wuhan, China. JAMA Cardiol. 2020;5(7):802–810.
- Soy M, Keser G, Atagündüz P, et al. Cytokine storm in COVID-19: pathogenesis and overview of anti-inflammatory agents. Clin Rheumatol. 2020;39(7):2085–2094.
- Baran Akpınar F, Tuncer M, Dayan A. Factors associated with admission to the intensive care unit in hospitalized COVID-19 patients. Turk J Fam Pract. 2020;26(3):124–130.
- Oncul M, Karakurt C, Elkiran O, et al. Evaluation of frequency, follow-up and treatment of multisystem inflammatory syndrome related to COVID-19. Ann Med Res. 2022;29(11):1238–1245.
- Madjid M, Safavi-Naeini P, Solomon SD, Vardeny O. Potential effects of coronaviruses on the cardiovascular system: a review. JAMA Cardiol. 2020;5(7):831–840.
- Gharibzadeh A, Shahsanaei F, Rahimi PN. Clinical and cardiovascular characteristics of patients suffering STEMI after COVID-19: a systematic review and meta-analysis. Curr Probl Cardiol. 2023;48(1):101045.
- Chung MK, Zidar DA, Bristow MR, et al. COVID-19 and cardiovascular disease: from bench to bedside. Circ Res. 2021;128(8):1214–1236.
- Siripanthong B, Nazarian S, Muser D, et al. Recognizing COVID-19-related myocarditis: pathophysiology and guideline for diagnosis and management. Heart Rhythm. 2020;17(9):1463–1471.
- Aktaş H, Yildirim O, Gül M, İnci S. Comparison of AMI patients undergoing coronary angiography during the COVID-19 pandemic and the pre-pandemic period. MN Cardiol. 2021;27(4):199.
- Koc H, Barutcu G, Duman H. Case report of STEMI due to early-stage multiple stent thrombosis accompanied by COVID-19. Rize Med J. 2023;1(4):20–25.
- Bikdeli B, Madhavan MV, Jimenez D, et al. COVID-19 and thrombotic or thromboembolic disease: implications for therapy and follow-up. J Am Coll Cardiol. 2020;75(23):2950–2973.
- Choudry FA, Hamshere SM, Rathod KS, et al. High thrombus burden in COVID-19 patients with STEMI. J Am Coll Cardiol. 2020;76(10):1168–1176.
- Ferhatbegovic L, Pojskic B. Characteristics of acute coronary syndrome during COVID-19 pandemic. Atherosclerosis. 2023;379:90.
- Welt FGP, Shah PB, Aronow HD, et al. Catheterization laboratory considerations during the COVID-19 pandemic. J Am Coll Cardiol. 2020;75(18):2372–235.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Eğitim Programları ve Öğretim (Diğer) |
| Bölüm | Research Article |
| Yazarlar | |
| Yayımlanma Tarihi | 28 Nisan 2025 |
| Gönderilme Tarihi | 2 Ekim 2024 |
| Kabul Tarihi | 28 Kasım 2024 |
| Yayımlandığı Sayı | Yıl 2025 Cilt: 2 Sayı: 1 |
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