Impact of COVID-19 on Thrombus Burden and Outcome in Acute Myocardial Infarction

Abstract

Background Cardiovascular manifestations are one of the most common complications in coronavirus disease 2019 (COVID-19) infection and are associated with increased mortality. However, the impact of COVID-19 infection on thrombus burden and the outcome of acute myocardial infarction (AMI) has not been studied. Methods This was a retrospective, observational study that included all adult patients (>18 years) diagnosed with AMI with or without COVID-19 infection. Epidemiological, laboratory, clinical, interventional, and outcome data were extracted and the impact of COVID-19 on thrombus burden and the primary clinical composite endpoint of all-cause death during hospital admission or 30 days after discharge was studied. Results The study population included 336 patients, including 56 patients with COVID and AMI and 280 patients with AMI without COVID-19 infection. Chest pain was the most common symptom (84.8%) while one or more co-morbidity was present in 117 (34.8%) patients. Forty-eight patients in the AMI with COVID group had ST-segment elevation myocardial infarction (STEMI) while 256 patients in the AMI without COVID group had STEMI, eight patients in the AMI with COVID group had non-ST-segment elevation myocardial infarction (NSTEMI), and 24 in the AMI without COVID group had NSTEMI. Patients with COVID-19 co-infection had a higher thrombus burden as compared to the patients without COVID-19 AMI group (p-value 0.008). The primary outcome in the form of all-cause mortality was seen in 13 (3.9%) patients, which was also more in the AMI with COVID group. Conclusion COVID-19 in AMI is a state of high thrombus burden associated with higher mortality, especially in patients with chronic co-morbidities.

Extensive right coronary artery thrombosis in a patient with COVID-19: A case report

“…The high thrombotic load in patients with AMI and COVID is known. In addition to the findings in other studies in the literature[ 14 , 15 ], there are also other important reports addressing this issue, such as a statement from the American College of Cardiology in which the authors concluded that patients with ST-segment elevation myocardial infarction and concurrent COVID-19 experienced a higher thrombotic burden than those without concurrent COVID-19[ 13 ].…”

COVID-19 infected ST-Elevation myocardial infarction in India (COSTA INDIA)

“…In our study, there was a trend towards higher in-hospital mortality in the COVID-19 positive STEMI patients. Most of the studies have reported a very high in-hospital mortality (12%–34%) among COVID-19 positive STEMI patients 1 , 2 , 3 , 7 , 8 , 9 , 10 , 11 , 12 . One possible explanation for the relatively lower in-hospital mortality in our study is the younger age of our study population (mean age 57 years), 8–10 years lower than patients in the above studies.…”

Hourly Valley Concentration of Air Pollutants Associated with Increased Acute Myocardial Infarction Hospital Admissions in Beijing, China

“…We analyzed AMI hospital admissions before the COVID-19 pandemic in Beijing, China, given its established impact on cardiovascular disease [18][19][20]. Data from 1 May 2014 to 31 December 2019 were obtained from the Beijing Municipal Health Commission Information Center.…”