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Angiographic and clinical outcome of SARS-CoV-2 positive patients with ST-segment elevation myocardial infarction undergoing primary angioplasty: A collaborative, individual patient data meta-analysis of six registry-based studies.
De Luca, Giuseppe; Silverio, Angelo; Verdoia, Monica; Siudak, Zbigniew; Tokarek, Tomasz; Kite, Thomas A; Gershlick, Anthony H; Rodriguez-Leor, Oriol; Cid-Alvarez, Belen; Jones, Daniel A; Rathod, Krishnaraj S; Montero-Cabezas, José M; Jurado-Roman, Alfonso; Nardin, Matteo; Galasso, Gennaro.
  • De Luca G; Division of Clinical and Experimental Cardiology, Azienda Ospedaliero-Universitaria Sassari, Viale S. Pietro, 43/B, Sassari 07100, Italy; Division of Clinical and Interventional Cardiology, Istituto Clinico Sant'Ambrogio, Milano, Italy. Electronic address: gdeluca@uniss.it.
  • Silverio A; Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Salerno, Italy.
  • Verdoia M; Division of Cardiology, Ospedale degli Infermi, ASL, Biella, Italy.
  • Siudak Z; Jan Kochanowski University, Kielce, Poland.
  • Tokarek T; Institute of Cardiology, Jagiellonian University Medical College, Kopernika 17 Street, Kraków 31-501, Poland; 2nd Department of Cardiology and Cardiovascular Interventions, University Hospital, Kraków, Poland.
  • Kite TA; Department of Cardiovascular Sciences and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, University of Leicester and University Hospitals of Leicester NHS Trust, Leicester, United Kingdom.
  • Gershlick AH; Department of Cardiovascular Sciences and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, University of Leicester and University Hospitals of Leicester NHS Trust, Leicester, United Kingdom.
  • Rodriguez-Leor O; Institut del Cor, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; CIBER de Enfermedades CardioVasculares (CIBERCV) Instituto de Salud Carlos III, Madrid, Spain; Institut de Recerca en Ciències de la Salut Germans Trias i Pujol, Badalona, Spain.
  • Cid-Alvarez B; Servicio de Cardiología, Hospital Clínico de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain.
  • Jones DA; Department of Cardiology, Barts Heart Centre, St. Bartholomew's Hospital, London, United Kingdom; Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University of London, London, United Kingdom.
  • Rathod KS; Department of Cardiology, Barts Heart Centre, St. Bartholomew's Hospital, London, United Kingdom; Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, Queen Mary University of London, London, United Kingdom.
  • Montero-Cabezas JM; Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands.
  • Jurado-Roman A; Department of Cardiology, Hospital Universitario La Paz., Madrid, Spain.
  • Nardin M; Department of Internal Medicine, Ospedale Riuniti, Brescia, Italy.
  • Galasso G; Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Salerno, Italy.
Eur J Intern Med ; 105: 69-76, 2022 11.
Статья в английский | MEDLINE | ID: covidwho-2086144
ABSTRACT

BACKGROUND:

The characteristics and outcome of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-positive patients with ST-Elevation Myocardial Infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI) are still poorly known.

METHODS:

The PANDEMIC study was an investigator-initiated, collaborative, individual patient data (IPD) meta-analysis of registry-based studies. MEDLINE, ScienceDirect, Web of Sciences, and SCOPUS were searched to identify all registry-based studies describing the characteristics and outcome of SARS-CoV-2-positive STEMI patients undergoing PPCI. The control group consisted of SARS-CoV-2-negative STEMI patients undergoing PPCI in the same time period from the ISACS-STEMI COVID 19 registry. The primary outcome was in-hospital mortality; the secondary outcome was postprocedural reperfusion assessed by TIMI flow.

RESULTS:

Of 8 registry-based studies identified, IPD were obtained from 6 studies including 941 SARS-CoV-2-positive patients; the control group included 2005 SARS-CoV-2-negative patients. SARS-CoV-2-positive patients showed a significantly higher in-hospital mortality (p < 0.001) and worse postprocedural TIMI flow (<3, p < 0.001) compared with SARS-CoV-2-negative subjects. The increased risk for SARS-CoV-2-positive patients was significantly higher in males compared to females for both the primary (pinteraction = 0.001) and secondary outcome (pinteraction = 0.023). In SARS-CoV-2-positive patients, age ≥ 75 years (OR = 5.72; 95%CI 1.77-18.5), impaired postprocedural TIMI flow (OR = 11.72; 95%CI 2.64-52.10), and cardiogenic shock at presentation (OR = 11.02; 95%CI 2.84-42.80) were independent predictors of mortality.

CONCLUSIONS:

In STEMI patients undergoing PPCI, SARS-CoV-2 positivity is independently associated with impaired reperfusion and with a higher risk of in-hospital mortality, especially among male patients. Age ≥ 75 years, cardiogenic shock, and impaired postprocedural TIMI flow independently predict mortality in this high-risk population.
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Полный текст: Имеется в наличии Коллекция: Международные базы данных база данных: MEDLINE Основная тема: Percutaneous Coronary Intervention / ST Elevation Myocardial Infarction / COVID-19 / Myocardial Infarction Тип исследования: Экспериментальные исследования / Прогностическое исследование / Отзывы Пределы темы: Пожилые / Женщины / Люди / Мужчины Язык: английский Журнал: Eur J Intern Med Тематика журнала: Внутренние болезни Год: 2022 Тип: Статья

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Полный текст: Имеется в наличии Коллекция: Международные базы данных база данных: MEDLINE Основная тема: Percutaneous Coronary Intervention / ST Elevation Myocardial Infarction / COVID-19 / Myocardial Infarction Тип исследования: Экспериментальные исследования / Прогностическое исследование / Отзывы Пределы темы: Пожилые / Женщины / Люди / Мужчины Язык: английский Журнал: Eur J Intern Med Тематика журнала: Внутренние болезни Год: 2022 Тип: Статья