The impact of COVID-19 on clinical outcomes among acute myocardial infarction patients undergoing early invasive treatment strategy.
The impact of COVID-19 on clinical outcomes among acute myocardial infarction patients undergoing early invasive treatment strategy.
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COVID-19对急性心肌梗塞患者的临床结局的影响。
DOI：
10.1002/clc.23908
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发表时间：
2022-10
影响因子：
2.7
通讯作者：
中科院分区：
文献类型：
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作者：
冠状病毒病2019 （COVID - 19）感染对急性心肌梗死（AMI）患者有创治疗策略后预后的影响尚未得到很好的研究。评估采用早期有创治疗策略的COVID - 19急性心肌梗死患者的预后。本研究是对国家COVID队列协作数据库的横断面回顾性分析，包括所有记录诊断为AMI （ST段抬高型心肌梗死（MI）和非ST段抬高型心肌梗死）的患者。COVID - 19阳性AMI患者被分为四组之一：（1a）在AMI发生后3天内进行冠状动脉造影并经皮冠状动脉介入治疗（PCI）的患者；（1b） AMI术后3天内PCI， 30天内行冠状动脉旁路移植术（CABG）；（2a） 30天内无PCI、无CABG的冠状动脉造影；（2b） 30天内冠状动脉造影合并冠脉搭桥。主要结局为呼吸衰竭、心源性休克、住院时间延长、再住院和死亡。诊断为AMI的COVID - 19阳性患者有10 506例。PCI治疗中，COVID - 19阳性患者呼吸衰竭的几率是COVID - 19阴性患者的8.2倍（p = 0.001）。在接受PCI治疗的COVID - 19患者中，延长住院时间的几率高出1.7倍（p = 0.024），在接受冠状动脉造影和CABG治疗的患者中，延长住院时间的几率高出1.9倍（p = 0.001）。这些数据表明，接受早期有创冠状动脉造影的COVID - 19阳性AMI患者的预后比COVID - 19阴性患者差。
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. To assess the outcomes of COVID‐19 patients presenting with AMI undergoing an early invasive treatment strategy. 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. 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). These data demonstrate that COVID‐19 positive patients with AMI undergoing early invasive coronary angiography had worse outcomes than COVID‐19 negative patients.