Mechanical Circulatory Support in Patients With COVID-19 Presenting With Myocardial Infarction.

Autor: Guddeti RR; Minneapolis Heart Institute Foundation at Abbott Northwestern Hospital, Minneapolis, Minnesota., Sanina C; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York., Jauhar R; North Shore University Hospital, Manhasset, New York., Henry TD; The Lindner Center for Research and Education, The Christ Hospital, Cincinnati, Ohio., Dehghani P; Prairie Vascular Research, Regina, Saskatchewan, Canada., Garberich R; Minneapolis Heart Institute Foundation at Abbott Northwestern Hospital, Minneapolis, Minnesota., Schmidt CW; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York., Nayak KR; Department of Cardiology, Scripps Mercy Hospital, San Diego, California., Shavadia JS; Royal University Hospital, University of Saskatchewan Saskatoon, Saskatchewan, Canada., Bagai A; St Michael's Hospital, Toronto, Ontario, Canada., Alraies C; DMC Harper University Hospital, Detroit, Michigan., Mehra A; Jersey Shore University Medical Center, Neptune, New Jersey., Bagur R; London Health Sciences Centre, London, Ontario, Canada., Grines C; Northside Hospital Cardiovascular Institute, Atlanta, Georgia., Singh A; North Shore University Hospital, Manhasset, New York., Patel RAG; Ochsner Health, University of Queensland Ochsner Clinical School, New Orleans, Louisiana., Htun WW; Gunderson Health, Onalaska, Wisconsin., Ghasemzadeh N; Georgia Heart Institute, Gainesville, Georgia., Davidson L; Northwestern University, Evanston, Illinois., Acharya D; University of Arizona Sarver Heart Center, Tuczon, Arizona., Kabour A; Mercy St Vincent's Medical Center, Toledo, Ohio., Hafiz AM; Southern Illinois University School of Medicine. Springfiled, Illinois., Amlani S; William Osler Health System, Ontario, Canada., Wasserman HS; Nuvance Health, Danbury Hospital. Danbury, Connecticut., Smith T; The Lindner Center for Research and Education, The Christ Hospital, Cincinnati, Ohio., Kapur NK; Tufts Medical Center, Boston, Massachusetts., Garcia S; The Lindner Center for Research and Education, The Christ Hospital, Cincinnati, Ohio. Electronic address: santiagogarcia@me.com.
Jazyk: angličtina
Zdroj: The American journal of cardiology [Am J Cardiol] 2023 Jan 15; Vol. 187, pp. 76-83. Date of Electronic Publication: 2022 Nov 29.
DOI: 10.1016/j.amjcard.2022.09.030
Abstrakt: ST-segment elevation myocardial infarction (STEMI) complicating COVID-19 is associated with an increased risk of cardiogenic shock and mortality. However, little is known about the frequency of use and clinical impact of mechanical circulatory support (MCS) in these patients. We sought to define patterns of MCS utilization, patient characteristics, and outcomes in patients with COVID-19 with STEMI. The NACMI (North American COVID-19 Myocardial Infarction) is an ongoing prospective, observational registry of patients with COVID-19 positive (COVID-19+) with STEMI with a contemporary control group of persons under investigation who subsequently tested negative for COVID-19 (COVID-19-). We compared the baseline characteristics and in-hospital outcomes of COVID-19+ and patients with COVID-19- according to the use of MCS. The primary outcome was a composite of in-hospital mortality, stroke, recurrent MI, and repeat unplanned revascularization. A total of 1,379 patients (586 COVID-19+ and 793 COVID-19-) enrolled in the NACMI registry between January 2020 and November 2021 were included in this analysis; overall, MCS use was 12.3% (12.1% [n = 71] COVID-19+/MCS positive [MCS+] vs 12.4% [n = 98] COVID-19-/MCS+). Baseline characteristics were similar between the 2 groups. The use of percutaneous coronary intervention was similar between the groups (84% vs 78%; p = 0.404). Intra-aortic balloon pump was the most frequently used MCS device in both groups (53% in COVID-19+/MCS+ and 75% in COVID-19-/MCS+). The primary outcome was significantly higher in COVID-19+/MCS+ patients (60% vs 30%; p = 0.001) because of very high in-hospital mortality (59% vs 28%; p = 0.001). In conclusion, patients with COVID-19+ with STEMI requiring MCS have very high in-hospital mortality, likely related to the significantly higher pulmonary involvement compared with patients with COVID-19- with STEMI requiring MCS.
(Copyright © 2022 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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