TY - JOUR
T1 - Initial Findings From the North American COVID-19 Myocardial Infarction Registry
AU - Society for Cardiac Angiography and Interventions, the Canadian Association of Interventional Cardiology, and the American College of Cardiology Interventional Council
AU - Garcia, Santiago
AU - Dehghani, Payam
AU - Grines, Cindy
AU - Davidson, Laura
AU - Nayak, Keshav R.
AU - Saw, Jacqueline
AU - Waksman, Ron
AU - Blair, John
AU - Akshay, Bagai
AU - Garberich, Ross
AU - Schmidt, Christian
AU - Ly, Hung Q.
AU - Sharkey, Scott
AU - Mercado, Nestor
AU - Alfonso, Carlos E.
AU - Misumida, Naoki
AU - Acharya, Deepak
AU - Madan, Mina
AU - Hafiz, Abdul Moiz
AU - Javed, Nosheen
AU - Shavadia, Jay
AU - Stone, Jay
AU - Alraies, M. Chadi
AU - Htun, Wah
AU - Downey, William
AU - Bergmark, Brian A.
AU - Ebinger, Jospeh
AU - Alyousef, Tareq
AU - Khalili, Houman
AU - Hwang, Chao Wei
AU - Purow, Joshua
AU - Llanos, Alexander
AU - McGrath, Brent
AU - Tannenbaum, Mark
AU - Resar, Jon
AU - Bagur, Rodrigo
AU - Cox-Alomar, Pedro
AU - Stefanescu Schmidt, Ada C.
AU - Cilia, Lindsey A.
AU - Jaffer, Farouc A.
AU - Gharacholou, Michael
AU - Salinger, Michael
AU - Case, Brian
AU - Kabour, Ameer
AU - Dai, Xuming
AU - Elkhateeb, Osama
AU - Kobayashi, Taisei
AU - Kim, Hahn Ho
AU - Roumia, Mazen
AU - Hall, Hurst M.
N1 - Publisher Copyright:
© 2021 American College of Cardiology Foundation
PY - 2021/4/27
Y1 - 2021/4/27
N2 - Background: The coronavirus disease 2019 (COVID-19) pandemic has impacted many aspects of ST-segment elevation myocardial infarction (STEMI) care, including timely access to primary percutaneous coronary intervention (PPCI). Objectives: The goal of the NACMI (North American COVID-19 and STEMI) registry is to describe demographic characteristics, management strategies, and outcomes of COVID-19 patients with STEMI. Methods: A prospective, ongoing observational registry was created under the guidance of 3 cardiology societies. STEMI patients with confirmed COVID+ (group 1) or suspected (person under investigation [PUI]) (group 2) COVID-19 infection were included. A group of age- and sex-matched STEMI patients (matched to COVID+ patients in a 2:1 ratio) treated in the pre-COVID era (2015 to 2019) serves as the control group for comparison of treatment strategies and outcomes (group 3). The primary outcome was a composite of in-hospital death, stroke, recurrent myocardial infarction, or repeat unplanned revascularization. Results: As of December 6, 2020, 1,185 patients were included in the NACMI registry (230 COVID+ patients, 495 PUIs, and 460 control patients). COVID+ patients were more likely to have minority ethnicity (Hispanic 23%, Black 24%) and had a higher prevalence of diabetes mellitus (46%) (all p < 0.001 relative to PUIs). COVID+ patients were more likely to present with cardiogenic shock (18%) but were less likely to receive invasive angiography (78%) (all p < 0.001 relative to control patients). Among COVID+ patients who received angiography, 71% received PPCI and 20% received medical therapy (both p < 0.001 relative to control patients). The primary outcome occurred in 36% of COVID+ patients, 13% of PUIs, and 5% of control patients (p < 0.001 relative to control patients). Conclusions: COVID+ patients with STEMI represent a high-risk group of patients with unique demographic and clinical characteristics. PPCI is feasible and remains the predominant reperfusion strategy, supporting current recommendations.
AB - Background: The coronavirus disease 2019 (COVID-19) pandemic has impacted many aspects of ST-segment elevation myocardial infarction (STEMI) care, including timely access to primary percutaneous coronary intervention (PPCI). Objectives: The goal of the NACMI (North American COVID-19 and STEMI) registry is to describe demographic characteristics, management strategies, and outcomes of COVID-19 patients with STEMI. Methods: A prospective, ongoing observational registry was created under the guidance of 3 cardiology societies. STEMI patients with confirmed COVID+ (group 1) or suspected (person under investigation [PUI]) (group 2) COVID-19 infection were included. A group of age- and sex-matched STEMI patients (matched to COVID+ patients in a 2:1 ratio) treated in the pre-COVID era (2015 to 2019) serves as the control group for comparison of treatment strategies and outcomes (group 3). The primary outcome was a composite of in-hospital death, stroke, recurrent myocardial infarction, or repeat unplanned revascularization. Results: As of December 6, 2020, 1,185 patients were included in the NACMI registry (230 COVID+ patients, 495 PUIs, and 460 control patients). COVID+ patients were more likely to have minority ethnicity (Hispanic 23%, Black 24%) and had a higher prevalence of diabetes mellitus (46%) (all p < 0.001 relative to PUIs). COVID+ patients were more likely to present with cardiogenic shock (18%) but were less likely to receive invasive angiography (78%) (all p < 0.001 relative to control patients). Among COVID+ patients who received angiography, 71% received PPCI and 20% received medical therapy (both p < 0.001 relative to control patients). The primary outcome occurred in 36% of COVID+ patients, 13% of PUIs, and 5% of control patients (p < 0.001 relative to control patients). Conclusions: COVID+ patients with STEMI represent a high-risk group of patients with unique demographic and clinical characteristics. PPCI is feasible and remains the predominant reperfusion strategy, supporting current recommendations.
KW - COVID-19
KW - ST-segment myocardial infarction
KW - outcomes
UR - http://www.scopus.com/inward/record.url?scp=85104051838&partnerID=8YFLogxK
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U2 - 10.1016/j.jacc.2021.02.055
DO - 10.1016/j.jacc.2021.02.055
M3 - Article
C2 - 33888249
AN - SCOPUS:85104051838
SN - 0735-1097
VL - 77
SP - 1994
EP - 2003
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 16
ER -