Impact of SARS-CoV-2 positivity on clinical outcome among STEMI patients undergoing mechanical reperfusion: Insights from the ISACS STEMI COVID 19 registry.
De Luca G., Debel N., Cercek M., Jensen LO., Vavlukis M., Calmac L., Johnson T., Ferrer GR., Ganyukov V., Wojakowski W., Kinnaird T., von Birgelen C., Cottin Y., IJsselmuiden A., Tuccillo B., Versaci F., Royaards K-J., Berg JT., Laine M., Dirksen M., Siviglia M., Casella G., Kala P., Díez Gil JL., Banning A., Becerra V., De Simone C., Santucci A., Carrillo X., Scoccia A., Amoroso G., Van't Hof AW., Kovarnik T., Tsigkas G., Mehilli J., Gabrielli G., Rios XF., Bakraceski N., Levesque S., Cirrincione G., Guiducci V., Kidawa M., Spedicato L., Marinucci L., Ludman P., Zilio F., Galasso G., Fabris E., Menichelli M., Garcia-Touchard A., Manzo S., Caiazzo G., Moreu J., Forés JS., Donazzan L., Vignali L., Teles R., Benit E., Agostoni P., Ojeda FB., Lehtola H., Camacho-Freiere S., Kraaijeveld A., Antti Y., Boccalatte M., Deharo P., Martínez-Luengas IL., Scheller B., Varytimiadi E., Moreno R., Uccello G., Faurie B., Gutierrez Barrios A., Milewski M., Bruwiere E., Smits P., Wilbert B., Di Uccio FS., Parodi G., Kedhi E., Verdoia M.
BACKGROUND AND AIMS: SARS-Cov-2 predisposes patients to thrombotic complications, due to excessive inflammation, endothelial dysfunction, platelet activation, and coagulation/fibrinolysis disturbances. The aim of the present study was to evaluate clinical characteristics and prognostic impact of SARS-CoV-2 positivity among STEMI patients undergoing primary percutaneous coronary intervention (PPCI). METHODS: We selected SARS-CoV-2 positive patients included in the ISACS-STEMI COVID-19, a retrospective multicenter European registry including 6609 STEMI patients treated with PPCI from March 1st until April 30th, in 2019 and 2020. As a reference group, we randomly sampled 5 SARS-Cov-2 negative patients per each SARS-CoV-2 positive patient, individually matched for age, sex, and hospital/geographic area. Study endpoints were in-hospital mortality, definite stent thrombosis, heart failure. RESULTS: Our population is represented by 62 positive SARS-CoV-2 positive patients who were compared with a matched population of 310 STEMI patients. No significant difference was observed in baseline characteristics or the modality of access to the PCI center. In the SARS-CoV-2 positive patients, the culprit lesion was more often located in the RCA (p