SARS-CoV-2 Positivity, Stent Thrombosis, and 30-day Mortality in STEMI Patients Undergoing Mechanical Reperfusion
Authors: De Luca Giuseppe , Algowhary Magdy , Uguz Berat , Oliveira Dinaldo C , Ganyukov Vladimir , Zimbakov Zan , Cercek Miha , Okkels Jensen Lisette , Loh Poay Huan , Calmac Lucian , Roura i Ferrer Gerard , Quadros Alexandre , Milewski Marek , Scotto Di Uccio Fortunato , von Birgelen Clemens , Versaci Francesco , Ten Berg Jurrien , Casella Gianni , Wong Sung Lung Aaron , Kala Petr , Díez Gil José Luis , Carrillo Xavier , Dirksen Maurits , Becerra-Munoz Victor M. , Kang-yin Lee Michael , Juzar Dafsah Arifa , de Moura Joaquim Rodrigo , De Simone Ciro , Milicic Davor , Davlouros Periklis , Bakraceski Nikola , Zilio Filippo , Donazzan Luca , Kraaijeveld Adriaan , Galasso Gennaro , Arpad Lux , Marinucci Lucia , Guiducci Vincenzo , Menichelli Maurizio , Scoccia Alessandra , Yamac Aylin Hatice , Ugur Mert Kadir , Flores Rios Xacobe , Kovarnik Tomas , Kidawa Michal , Moreu Josè , Flavien Vincent , Fabris Enrico , Lozano Martínez-Luengas Iñigo , Boccalatte Marco , Bosa Ojeda Francisco , Arellano-Serrano Carlos , Caiazzo Gianluca , Cirrincione Giuseppe , Kao Hsien-Li , Sanchis Forés Juan , Vignali Luigi , Pereira Helder , Manzo-Silbermann Stephane , Ordoñez Santiago , Arat Özkan Alev , Scheller Bruno , Lehtola Heidi , Teles Rui , Mantis Christos , Antti Ylitalo , Brum Silveira João António , Bessonov Ivan , Zoni Rodrigo , Savonitto Stefano , Kochiadakis George , Alexopoulos Dimitrios , Uribe Carlos E , Kanakakis John , Faurie Benjamin , Gabrielli Gabriele , Gutierrez Barrios Alejandro , Bachini Juan Pablo , Rocha Alex , Tam Frankie Chor-Cheung , Rodriguez Alfredo , Lukito Antonia Anna , Bellemain-Appaix Anne , Pessah Gustavo , Cortese Giuliana , Parodi Guido , Burgadha Mohammed Abed , Kedhi Elvin , Lamelas Pablo , Suryapranata Harry , Nardin Matteo , Verdoia Monica 
Published: October 2022

SARS-Cov-2 has been suggested to promote thrombotic complications and higher mortality. The aim of the present study was to evaluate the impact of SARS-CoV-2 positivity on in-hospital outcome and 30-day mortality in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI) enrolled in the International Survey on Acute Coronary Syndromes ST-segment elevation Myocardial Infarction (ISACS-STEMI COVID-19 registry. The 109 SARS-CoV-2 positive patients were compared with 2005 SARS-CoV-2 negative patients. Positive patients were older ( P = .002), less often active smokers ( P = .002), and hypercholesterolemic ( P = .006), they presented more often later than 12 h ( P = .037), more often to the hub and were more often in cardiogenic shock ( P = .02), or requiring rescue percutaneous coronary intervention after failed thrombolysis (P < .0001). Lower postprocedural Thrombolysis in Myocardial Infarction 3 flow ( P = .029) and more thrombectomy ( P = .046) were observed. SARS-CoV-2 was associated with a significantly higher in-hospital mortality (25.7 vs 7%, adjusted Odds Ratio (OR) [95% Confidence Interval] = 3.2 [1.71-5.99], P < .001) in-hospital definite in-stent thrombosis (6.4 vs 1.1%, adjusted Odds Ratio [95% CI] = 6.26 [2.41-16.25], P < .001) and 30-day mortality (34.4 vs 8.5%, adjusted Hazard Ratio [95% CI] = 2.16 [1.45-3.23], P < .001), confirming that SARS-CoV-2 positivity is associated with impaired reperfusion, with negative prognostic consequences.