Open AccessThe impact of COVID‐19 on clinical outcomes among acute myocardial infarction patients undergoing early invasive treatment strategy
Author(s) -
Sharma Prerna,
Shah Kajal,
Loomba Johanna,
Patel Arti,
Mallawaarachchi Indika,
Blazek Olivia,
Ratcliffe Sarah,
Breathett Khadijah,
Johnson Amber E.,
Taylor Angela M.,
Salerno Michael,
Ragosta Michael,
Sodhi Nishtha,
Addison Daniel,
Mohammed Selma,
Bilchick Kenneth C.,
Mazimba Sula
Publication year - 2022
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.23908
Subject(s) - medicine , myocardial infarction , percutaneous coronary intervention , conventional pci , cardiogenic shock , cardiology , coronary artery disease , odds ratio , retrospective cohort study
Background The implications of coronavirus disease 2019 (COVID‐19) infection on outcomes after invasive therapeutic strategies among patients presenting with acute myocardial infarction (AMI) are not well studied. Hypothesis To assess the outcomes of COVID‐19 patients presenting with AMI undergoing an early invasive treatment strategy. Methods This study was a cross‐sectional, retrospective analysis of the National COVID Cohort Collaborative database including all patients presenting with a recorded diagnosis of AMI (ST‐elevation myocardial infarction (MI) and non‐ST elevation MI). COVID‐19 positive patients with AMI were stratified into one of four groups: (1a) patients who had a coronary angiogram with percutaneous coronary intervention (PCI) within 3 days of their AMI; (1b) PCI within 3 days of AMI with coronary artery bypass graft (CABG) within 30 days; (2a) coronary angiogram without PCI and without CABG within 30 days; and (2b) coronary angiogram with CABG within 30 days. The main outcomes were respiratory failure, cardiogenic shock, prolonged length of stay, rehospitalization, and death. Results There were 10 506 COVID‐19 positive patients with a diagnosis of AMI. COVID‐19 positive patients with PCI had 8.2 times higher odds of respiratory failure than COVID‐19 negative patients ( p = .001). The odds of prolonged length of stay were 1.7 times higher in COVID‐19 patients who underwent PCI ( p = .024) and 1.9 times higher in patients who underwent coronary angiogram followed by CABG ( p = .001). Conclusion These data demonstrate that COVID‐19 positive patients with AMI undergoing early invasive coronary angiography had worse outcomes than COVID‐19 negative patients.