Changes in characteristics and management among patients with ST‐elevation myocardial infarction due to COVID‐19 infection
Objectives To assess changes in characteristics and management among ST‐elevation myocardial infarction (STEMI) patients with coronavirus disease (COVID‐19) who underwent primary percutaneous coronary intervention. Methods Our prospective, monocentric study enrolled all STEMI patients who underwent...
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| Veröffentlicht in: | Catheterization and cardiovascular interventions 2021-02, Vol.97 (3), p.E319-E326 |
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| creator | Popovic, Batric Varlot, Jeanne Metzdorf, Pierre Adrien Jeulin, Hélène Goehringer, François Camenzind, Edoardo |
| description | Objectives
To assess changes in characteristics and management among ST‐elevation myocardial infarction (STEMI) patients with coronavirus disease (COVID‐19) who underwent primary percutaneous coronary intervention.
Methods
Our prospective, monocentric study enrolled all STEMI patients who underwent PPCI during the COVID‐19 outbreak (n = 83). This cohort was first compared with a previous cohort of STEMI patients (2008–2017, n = 1,552 patients) and was then dichotomized into a non‐COVID‐19 group (n = 72) and COVID‐19 group (n = 11).
Results
In comparison with the pre‐outbreak period, patients during the outbreak period were older (59.6 ± 12.9 vs. 62.6 ± 12.2, p = .03) with a delayed seek to care (mean delay first symptoms‐balloon 3.8 ± 3 vs. .7.4 ± 7.7, p |
| doi_str_mv | 10.1002/ccd.29114 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7405489</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2490705808</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3864-a0def31cd33d48889af557a83be21667e8539433767e2573ca159bbc2034a6a3</originalsourceid><addsrcrecordid>eNp1kc1u1DAUhSMEoqWw4AWQJTawmNZ_SewNEkr5qVSpC0aInXXHuZlxldiDnbSaTdVH4Bl5EtyZaVWQWPn6nk9H9-gUxWtGjxml_MTa9phrxuST4pCVnM9qXv14up-ZltVB8SKlS0qprrh-XhwIXlV1hg6Lm2YFfomJOE_sCiLYEaNLo7OJgG_JAB6WOKAfCQzBL8kaRpd_iVy7cUW-zX_f_sIer_I2eDJsgoXYOuizXwfRbrfthGQMpLn4fnaacabvRNxqL4tnHfQJX-3fo2L--dO8-To7v_hy1nw8n1mhKjkD2mInmG2FaKVSSkNXljUosUDOchRUpdBSiDqPvKyFBVbqxcJyKiRUII6KDzvb9bQYsLU5QITerKMbIG5MAGf-VrxbmWW4MrWkpVQ6G7zbG8Twc8I0msEli30PHsOUDJdcMsoVZRl9-w96Gaboc7pMaVrTUlGVqfc7ysaQUsTu4RhGzV2pJpdqtqVm9s3j6x_I-xYzcLIDrl2Pm_87maY53Vn-ATkTrpY</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2490705808</pqid></control><display><type>article</type><title>Changes in characteristics and management among patients with ST‐elevation myocardial infarction due to COVID‐19 infection</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Popovic, Batric ; Varlot, Jeanne ; Metzdorf, Pierre Adrien ; Jeulin, Hélène ; Goehringer, François ; Camenzind, Edoardo</creator><creatorcontrib>Popovic, Batric ; Varlot, Jeanne ; Metzdorf, Pierre Adrien ; Jeulin, Hélène ; Goehringer, François ; Camenzind, Edoardo</creatorcontrib><description>Objectives
To assess changes in characteristics and management among ST‐elevation myocardial infarction (STEMI) patients with coronavirus disease (COVID‐19) who underwent primary percutaneous coronary intervention.
Methods
Our prospective, monocentric study enrolled all STEMI patients who underwent PPCI during the COVID‐19 outbreak (n = 83). This cohort was first compared with a previous cohort of STEMI patients (2008–2017, n = 1,552 patients) and was then dichotomized into a non‐COVID‐19 group (n = 72) and COVID‐19 group (n = 11).
Results
In comparison with the pre‐outbreak period, patients during the outbreak period were older (59.6 ± 12.9 vs. 62.6 ± 12.2, p = .03) with a delayed seek to care (mean delay first symptoms‐balloon 3.8 ± 3 vs. .7.4 ± 7.7, p < .001) resulting in a two‐fold higher in‐hospital mortality (non COVID‐19 4.3% vs. COVID‐19 8.4%, p = .07). Among the 83 STEMI patients admitted during the outbreak period, 11 patients were infected by COVID‐19. Higher biological markers of inflammation (C‐reactive protein: 28 ± 39 vs. 98 ± 97 mg/L, p = .04), of fibrinolysis (D‐dimer: 804 ± 1,500 vs. 3,128 ± 2,458 μg/L, p = .02), and antiphospholipid antibodies in four cases were observed in the COVID‐19 group. In this group, angiographic data also differed: a thrombotic myocardial infarction nonatherosclerotic coronary occlusion (MINOCA) was observed in 11 cases (1.4% vs. 54.5%, p < .001) and associated with higher post‐procedure distal embolization (30.6% vs. 72.7%, p = .007). The in hospital mortality was significantly higher in the COVID‐19 group (5.6% vs. 27.3%, p = .016).
Conclusion
The COVID‐19 outbreak implies deep changes in the etiopathogenesis and therapeutic management of STEMI patients with COVID‐19. The impact on early and long‐term outcomes of systemic inflammation and hypercoagulability in this specific population is warranted.</description><identifier>ISSN: 1522-1946</identifier><identifier>ISSN: 1522-726X</identifier><identifier>EISSN: 1522-726X</identifier><identifier>DOI: 10.1002/ccd.29114</identifier><identifier>PMID: 32667726</identifier><language>eng</language><publisher>Hoboken, USA: John Wiley & Sons, Inc</publisher><subject>Acute myocardial infarction/STEMI ; Aged ; Aged, 80 and over ; Antiphospholipid antibodies ; Biomarkers ; Cohort Studies ; Coronary Artery Disease ; Coronaviruses ; COVID-19 ; COVID-19 - complications ; COVID-19 - mortality ; COVID-19 - therapy ; Embolization ; Female ; Fibrinolysis ; France ; Heart attacks ; Hospital Mortality ; Hospitalization ; Humans ; Inflammation ; Male ; Middle Aged ; Mortality ; Myocardial infarction ; Occlusion ; Original Studies ; Outbreaks ; Percutaneous Coronary Intervention ; ST Elevation Myocardial Infarction - mortality ; ST Elevation Myocardial Infarction - therapy ; ST Elevation Myocardial Infarction - virology ; Stents ; Treatment Outcome</subject><ispartof>Catheterization and cardiovascular interventions, 2021-02, Vol.97 (3), p.E319-E326</ispartof><rights>2020 Wiley Periodicals LLC.</rights><rights>2021 Wiley Periodicals LLC.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3864-a0def31cd33d48889af557a83be21667e8539433767e2573ca159bbc2034a6a3</citedby><cites>FETCH-LOGICAL-c3864-a0def31cd33d48889af557a83be21667e8539433767e2573ca159bbc2034a6a3</cites><orcidid>0000-0002-2454-6468</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fccd.29114$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fccd.29114$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,777,781,882,1412,27905,27906,45555,45556</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32667726$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Popovic, Batric</creatorcontrib><creatorcontrib>Varlot, Jeanne</creatorcontrib><creatorcontrib>Metzdorf, Pierre Adrien</creatorcontrib><creatorcontrib>Jeulin, Hélène</creatorcontrib><creatorcontrib>Goehringer, François</creatorcontrib><creatorcontrib>Camenzind, Edoardo</creatorcontrib><title>Changes in characteristics and management among patients with ST‐elevation myocardial infarction due to COVID‐19 infection</title><title>Catheterization and cardiovascular interventions</title><addtitle>Catheter Cardiovasc Interv</addtitle><description>Objectives
To assess changes in characteristics and management among ST‐elevation myocardial infarction (STEMI) patients with coronavirus disease (COVID‐19) who underwent primary percutaneous coronary intervention.
Methods
Our prospective, monocentric study enrolled all STEMI patients who underwent PPCI during the COVID‐19 outbreak (n = 83). This cohort was first compared with a previous cohort of STEMI patients (2008–2017, n = 1,552 patients) and was then dichotomized into a non‐COVID‐19 group (n = 72) and COVID‐19 group (n = 11).
Results
In comparison with the pre‐outbreak period, patients during the outbreak period were older (59.6 ± 12.9 vs. 62.6 ± 12.2, p = .03) with a delayed seek to care (mean delay first symptoms‐balloon 3.8 ± 3 vs. .7.4 ± 7.7, p < .001) resulting in a two‐fold higher in‐hospital mortality (non COVID‐19 4.3% vs. COVID‐19 8.4%, p = .07). Among the 83 STEMI patients admitted during the outbreak period, 11 patients were infected by COVID‐19. Higher biological markers of inflammation (C‐reactive protein: 28 ± 39 vs. 98 ± 97 mg/L, p = .04), of fibrinolysis (D‐dimer: 804 ± 1,500 vs. 3,128 ± 2,458 μg/L, p = .02), and antiphospholipid antibodies in four cases were observed in the COVID‐19 group. In this group, angiographic data also differed: a thrombotic myocardial infarction nonatherosclerotic coronary occlusion (MINOCA) was observed in 11 cases (1.4% vs. 54.5%, p < .001) and associated with higher post‐procedure distal embolization (30.6% vs. 72.7%, p = .007). The in hospital mortality was significantly higher in the COVID‐19 group (5.6% vs. 27.3%, p = .016).
Conclusion
The COVID‐19 outbreak implies deep changes in the etiopathogenesis and therapeutic management of STEMI patients with COVID‐19. The impact on early and long‐term outcomes of systemic inflammation and hypercoagulability in this specific population is warranted.</description><subject>Acute myocardial infarction/STEMI</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Antiphospholipid antibodies</subject><subject>Biomarkers</subject><subject>Cohort Studies</subject><subject>Coronary Artery Disease</subject><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>COVID-19 - complications</subject><subject>COVID-19 - mortality</subject><subject>COVID-19 - therapy</subject><subject>Embolization</subject><subject>Female</subject><subject>Fibrinolysis</subject><subject>France</subject><subject>Heart attacks</subject><subject>Hospital Mortality</subject><subject>Hospitalization</subject><subject>Humans</subject><subject>Inflammation</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Myocardial infarction</subject><subject>Occlusion</subject><subject>Original Studies</subject><subject>Outbreaks</subject><subject>Percutaneous Coronary Intervention</subject><subject>ST Elevation Myocardial Infarction - mortality</subject><subject>ST Elevation Myocardial Infarction - therapy</subject><subject>ST Elevation Myocardial Infarction - virology</subject><subject>Stents</subject><subject>Treatment Outcome</subject><issn>1522-1946</issn><issn>1522-726X</issn><issn>1522-726X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kc1u1DAUhSMEoqWw4AWQJTawmNZ_SewNEkr5qVSpC0aInXXHuZlxldiDnbSaTdVH4Bl5EtyZaVWQWPn6nk9H9-gUxWtGjxml_MTa9phrxuST4pCVnM9qXv14up-ZltVB8SKlS0qprrh-XhwIXlV1hg6Lm2YFfomJOE_sCiLYEaNLo7OJgG_JAB6WOKAfCQzBL8kaRpd_iVy7cUW-zX_f_sIer_I2eDJsgoXYOuizXwfRbrfthGQMpLn4fnaacabvRNxqL4tnHfQJX-3fo2L--dO8-To7v_hy1nw8n1mhKjkD2mInmG2FaKVSSkNXljUosUDOchRUpdBSiDqPvKyFBVbqxcJyKiRUII6KDzvb9bQYsLU5QITerKMbIG5MAGf-VrxbmWW4MrWkpVQ6G7zbG8Twc8I0msEli30PHsOUDJdcMsoVZRl9-w96Gaboc7pMaVrTUlGVqfc7ysaQUsTu4RhGzV2pJpdqtqVm9s3j6x_I-xYzcLIDrl2Pm_87maY53Vn-ATkTrpY</recordid><startdate>20210215</startdate><enddate>20210215</enddate><creator>Popovic, Batric</creator><creator>Varlot, Jeanne</creator><creator>Metzdorf, Pierre Adrien</creator><creator>Jeulin, Hélène</creator><creator>Goehringer, François</creator><creator>Camenzind, Edoardo</creator><general>John Wiley & Sons, Inc</general><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-2454-6468</orcidid></search><sort><creationdate>20210215</creationdate><title>Changes in characteristics and management among patients with ST‐elevation myocardial infarction due to COVID‐19 infection</title><author>Popovic, Batric ; Varlot, Jeanne ; Metzdorf, Pierre Adrien ; Jeulin, Hélène ; Goehringer, François ; Camenzind, Edoardo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3864-a0def31cd33d48889af557a83be21667e8539433767e2573ca159bbc2034a6a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Acute myocardial infarction/STEMI</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Antiphospholipid antibodies</topic><topic>Biomarkers</topic><topic>Cohort Studies</topic><topic>Coronary Artery Disease</topic><topic>Coronaviruses</topic><topic>COVID-19</topic><topic>COVID-19 - complications</topic><topic>COVID-19 - mortality</topic><topic>COVID-19 - therapy</topic><topic>Embolization</topic><topic>Female</topic><topic>Fibrinolysis</topic><topic>France</topic><topic>Heart attacks</topic><topic>Hospital Mortality</topic><topic>Hospitalization</topic><topic>Humans</topic><topic>Inflammation</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Myocardial infarction</topic><topic>Occlusion</topic><topic>Original Studies</topic><topic>Outbreaks</topic><topic>Percutaneous Coronary Intervention</topic><topic>ST Elevation Myocardial Infarction - mortality</topic><topic>ST Elevation Myocardial Infarction - therapy</topic><topic>ST Elevation Myocardial Infarction - virology</topic><topic>Stents</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Popovic, Batric</creatorcontrib><creatorcontrib>Varlot, Jeanne</creatorcontrib><creatorcontrib>Metzdorf, Pierre Adrien</creatorcontrib><creatorcontrib>Jeulin, Hélène</creatorcontrib><creatorcontrib>Goehringer, François</creatorcontrib><creatorcontrib>Camenzind, Edoardo</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Catheterization and cardiovascular interventions</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Popovic, Batric</au><au>Varlot, Jeanne</au><au>Metzdorf, Pierre Adrien</au><au>Jeulin, Hélène</au><au>Goehringer, François</au><au>Camenzind, Edoardo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Changes in characteristics and management among patients with ST‐elevation myocardial infarction due to COVID‐19 infection</atitle><jtitle>Catheterization and cardiovascular interventions</jtitle><addtitle>Catheter Cardiovasc Interv</addtitle><date>2021-02-15</date><risdate>2021</risdate><volume>97</volume><issue>3</issue><spage>E319</spage><epage>E326</epage><pages>E319-E326</pages><issn>1522-1946</issn><issn>1522-726X</issn><eissn>1522-726X</eissn><abstract>Objectives
To assess changes in characteristics and management among ST‐elevation myocardial infarction (STEMI) patients with coronavirus disease (COVID‐19) who underwent primary percutaneous coronary intervention.
Methods
Our prospective, monocentric study enrolled all STEMI patients who underwent PPCI during the COVID‐19 outbreak (n = 83). This cohort was first compared with a previous cohort of STEMI patients (2008–2017, n = 1,552 patients) and was then dichotomized into a non‐COVID‐19 group (n = 72) and COVID‐19 group (n = 11).
Results
In comparison with the pre‐outbreak period, patients during the outbreak period were older (59.6 ± 12.9 vs. 62.6 ± 12.2, p = .03) with a delayed seek to care (mean delay first symptoms‐balloon 3.8 ± 3 vs. .7.4 ± 7.7, p < .001) resulting in a two‐fold higher in‐hospital mortality (non COVID‐19 4.3% vs. COVID‐19 8.4%, p = .07). Among the 83 STEMI patients admitted during the outbreak period, 11 patients were infected by COVID‐19. Higher biological markers of inflammation (C‐reactive protein: 28 ± 39 vs. 98 ± 97 mg/L, p = .04), of fibrinolysis (D‐dimer: 804 ± 1,500 vs. 3,128 ± 2,458 μg/L, p = .02), and antiphospholipid antibodies in four cases were observed in the COVID‐19 group. In this group, angiographic data also differed: a thrombotic myocardial infarction nonatherosclerotic coronary occlusion (MINOCA) was observed in 11 cases (1.4% vs. 54.5%, p < .001) and associated with higher post‐procedure distal embolization (30.6% vs. 72.7%, p = .007). The in hospital mortality was significantly higher in the COVID‐19 group (5.6% vs. 27.3%, p = .016).
Conclusion
The COVID‐19 outbreak implies deep changes in the etiopathogenesis and therapeutic management of STEMI patients with COVID‐19. The impact on early and long‐term outcomes of systemic inflammation and hypercoagulability in this specific population is warranted.</abstract><cop>Hoboken, USA</cop><pub>John Wiley & Sons, Inc</pub><pmid>32667726</pmid><doi>10.1002/ccd.29114</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-2454-6468</orcidid><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 1522-1946 |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Acute myocardial infarction/STEMI Aged Aged, 80 and over Antiphospholipid antibodies Biomarkers Cohort Studies Coronary Artery Disease Coronaviruses COVID-19 COVID-19 - complications COVID-19 - mortality COVID-19 - therapy Embolization Female Fibrinolysis France Heart attacks Hospital Mortality Hospitalization Humans Inflammation Male Middle Aged Mortality Myocardial infarction Occlusion Original Studies Outbreaks Percutaneous Coronary Intervention ST Elevation Myocardial Infarction - mortality ST Elevation Myocardial Infarction - therapy ST Elevation Myocardial Infarction - virology Stents Treatment Outcome |
| title | Changes in characteristics and management among patients with ST‐elevation myocardial infarction due to COVID‐19 infection |
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