The Pragmatic Role of Covid-19 on the Thrombus Grade of Patients With Contemporary St-Segment-Elevation Myocardial Infarction



Firouzi A¹ ; Hosseini Z¹ ; Norouzi Z¹ ; Hosseini Z¹ ; Amirpour A² ; Talakoob H³ ; Amin A⁴ ; Soleimani A⁵ ; Moradifar N⁴ ; Karbalai S⁵ ; Mozafarybazargani M³ ; Hekmat H⁶ ; Maleki M¹ ; Sadeghipour P¹ Show All Authors Show Affiliations
Source: Journal of Tehran University Heart Center Published:2022

Abstract

Background: Limited data exist on the clinical outcomes of patients with coronavirus disease 2019 (COVID-19) presenting with ST-segment-elevation myocardial infarction (STEMI). Methods: This multicenter study, conducted in 6 centers in Iran, aimed to compare baseline clinical and procedural data between a case group, comprising STEMI patients with COVID-19, and a control group, comprising STEMI patients before the COVID-19 pandemic, and to determine in-hospital infarct-related artery thrombus grades and major adverse cardio-cerebrovascular events (MACCEs), defined as a composite of deaths from any cause (cardiovascular and noncardiovascular), nonfatal strokes, and stent thrombosis. Results: No significant differences were observed between the 2 groups regarding baseline characteristics. Primary percutaneous coronary intervention (PPCI) was performed in 72.9% of the cases and 98.5% of the controls (P=0.043), and primary coronary artery bypass grafting was performed in 6.2% of the cases and 1.4% of the controls (P=0.048). Successful PPCI procedures (final TIMI flow grade III) were significantly fewer in the case group (66.5% vs 93.5%; P=0.001). The baseline thrombus grade before wire crossing was not statistically significantly different between the 2 groups. The summation of thrombus grades IV and V was 75% in the case group and 82% in the control group (P=0.432). The rate of MACCEs was 14.5% and 2.1% in the case and control groups, respectively (P=0.002). Conclusion: In our study, the thrombus grade had no significant differences between the case and control groups; however, the in-hospital rates of the no-reflow phenomenon, periprocedural MI, mechanical complications, and MACCEs were statistically significantly higher in the case group. © 2022 Tehran University of Medical Sciences.