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The Challenge of High Coronary Thrombotic Events in Patients with ST-Segment Elevation Myocardial Infarction and COVID-19

The aim of this observational study was to describe the characteristics and outcomes of coronavirus disease 2019 (COVID-19)-positive patients with ST-segment elevation myocardial infarction (STEMI), with a special focus on factors associated with a high risk of coronary thrombosis and in-hospital mo...

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Autores principales: Anghel, Larisa, Tudurachi, Bogdan-Sorin, Leonte, Andreea, Sascău, Radu Andy, Zota, Ioana Mădălina, Bazyani, Amin, Tinică, Grigore, Stătescu, Cristian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9654578/
https://www.ncbi.nlm.nih.gov/pubmed/36362770
http://dx.doi.org/10.3390/jcm11216542
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author Anghel, Larisa
Tudurachi, Bogdan-Sorin
Leonte, Andreea
Sascău, Radu Andy
Zota, Ioana Mădălina
Bazyani, Amin
Tinică, Grigore
Stătescu, Cristian
author_facet Anghel, Larisa
Tudurachi, Bogdan-Sorin
Leonte, Andreea
Sascău, Radu Andy
Zota, Ioana Mădălina
Bazyani, Amin
Tinică, Grigore
Stătescu, Cristian
author_sort Anghel, Larisa
collection PubMed
description The aim of this observational study was to describe the characteristics and outcomes of coronavirus disease 2019 (COVID-19)-positive patients with ST-segment elevation myocardial infarction (STEMI), with a special focus on factors associated with a high risk of coronary thrombosis and in-hospital mortality. Comparing the two groups of patients with STEMI separated according to the presence of SARS-CoV-2 infections, it was observed that COVID-19 patients were more likely to present with dyspnea (82.43% vs. 61.41%, p = 0.048) and cardiogenic shock (10.52% vs. 5.40%, p = 0.012). A longer total ischemia time was observed in COVID-19 patients, and they were twice as likely to undergo coronary angiography more than 12 hours after the onset of symptoms (19.29% vs. 10.13%, p = 0.024). In 10 of 57 COVID-19-positive patients, a primary PCI was not necessary, and only thromboaspiration was performed (17.54% vs. 2.70%, p < 0.001). Platelet level was inversely correlated (r = −0.512, p = 0.025) with a higher risk of coronary thrombosis without an atherosclerotic lesion. Using a cut-off value of 740 ng/ml, D-dimers predicted a higher risk of coronary thrombosis, with a sensitivity of 80% and a specificity of 66% (ROC area under the curve: 0.826, 95% CI: 0.716–0.935, p = 0.001). These are novel findings that raise the question of whether more aggressive antithrombotic therapy is necessary for selected COVID-19 and STEMI patients.
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spelling pubmed-96545782022-11-15 The Challenge of High Coronary Thrombotic Events in Patients with ST-Segment Elevation Myocardial Infarction and COVID-19 Anghel, Larisa Tudurachi, Bogdan-Sorin Leonte, Andreea Sascău, Radu Andy Zota, Ioana Mădălina Bazyani, Amin Tinică, Grigore Stătescu, Cristian J Clin Med Article The aim of this observational study was to describe the characteristics and outcomes of coronavirus disease 2019 (COVID-19)-positive patients with ST-segment elevation myocardial infarction (STEMI), with a special focus on factors associated with a high risk of coronary thrombosis and in-hospital mortality. Comparing the two groups of patients with STEMI separated according to the presence of SARS-CoV-2 infections, it was observed that COVID-19 patients were more likely to present with dyspnea (82.43% vs. 61.41%, p = 0.048) and cardiogenic shock (10.52% vs. 5.40%, p = 0.012). A longer total ischemia time was observed in COVID-19 patients, and they were twice as likely to undergo coronary angiography more than 12 hours after the onset of symptoms (19.29% vs. 10.13%, p = 0.024). In 10 of 57 COVID-19-positive patients, a primary PCI was not necessary, and only thromboaspiration was performed (17.54% vs. 2.70%, p < 0.001). Platelet level was inversely correlated (r = −0.512, p = 0.025) with a higher risk of coronary thrombosis without an atherosclerotic lesion. Using a cut-off value of 740 ng/ml, D-dimers predicted a higher risk of coronary thrombosis, with a sensitivity of 80% and a specificity of 66% (ROC area under the curve: 0.826, 95% CI: 0.716–0.935, p = 0.001). These are novel findings that raise the question of whether more aggressive antithrombotic therapy is necessary for selected COVID-19 and STEMI patients. MDPI 2022-11-04 /pmc/articles/PMC9654578/ /pubmed/36362770 http://dx.doi.org/10.3390/jcm11216542 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Anghel, Larisa
Tudurachi, Bogdan-Sorin
Leonte, Andreea
Sascău, Radu Andy
Zota, Ioana Mădălina
Bazyani, Amin
Tinică, Grigore
Stătescu, Cristian
The Challenge of High Coronary Thrombotic Events in Patients with ST-Segment Elevation Myocardial Infarction and COVID-19
title The Challenge of High Coronary Thrombotic Events in Patients with ST-Segment Elevation Myocardial Infarction and COVID-19
title_full The Challenge of High Coronary Thrombotic Events in Patients with ST-Segment Elevation Myocardial Infarction and COVID-19
title_fullStr The Challenge of High Coronary Thrombotic Events in Patients with ST-Segment Elevation Myocardial Infarction and COVID-19
title_full_unstemmed The Challenge of High Coronary Thrombotic Events in Patients with ST-Segment Elevation Myocardial Infarction and COVID-19
title_short The Challenge of High Coronary Thrombotic Events in Patients with ST-Segment Elevation Myocardial Infarction and COVID-19
title_sort challenge of high coronary thrombotic events in patients with st-segment elevation myocardial infarction and covid-19
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9654578/
https://www.ncbi.nlm.nih.gov/pubmed/36362770
http://dx.doi.org/10.3390/jcm11216542
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