1. Risk factors for in-hospital mortality in patients with acute myocardial infarction during the COVID-19 outbreak
- Author
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José Luis Zamorano, Enrique Gutiérrez Ibañes, Fernando Sarnago, Ignacio J. Amat-Santos, Ángel Sánchez-Recalde, Sandra Santos Martínez, Jorge Solano-López, Jessika González D’Gregorio, José Luis Mestre, Roberto Mateos Gaitán, Marcelo Sanmartín, Juan Ramón Rey Blas, Juan Sanchis, Nicolás Manuel Maneiro-Melón, Ana Pardo Sanz, Joan Antoni Gómez-Hospital, and Luisa Salido
- Subjects
Male ,ARDS ,medicine.medical_specialty ,Acute coronary syndrome ,Myocardial Infarction ,Comorbidity ,030204 cardiovascular system & hematology ,Logistic regression ,Risk Assessment ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Internal medicine ,medicine ,Humans ,Síndrome coronario agudo ,Myocardial infarction ,Hospital Mortality ,Prospective Studies ,Mortality ,Pandemics ,ARDS, acute respiratory distress syndrome ,COVID-19, coronavirus disease 2019 ,Aged ,Retrospective Studies ,PCI, percutaneous coronary intervention ,business.industry ,SARS-CoV-2 ,NSTEMI, non-ST-segment elevation myocardial infarction ,Outbreak ,COVID-19 ,STEMI, ST-segment elevation myocardial infarction ,General Medicine ,Middle Aged ,medicine.disease ,AMI, acute myocardial infarction ,Spain ,Conventional PCI ,Propensity score matching ,Mortalidad ,Original Article ,Female ,Infarto de miocardio ,business ,Cohort study ,Follow-Up Studies - Abstract
Introduction and objectives Despite advances in treatment, patients with acute myocardial infarction (AMI) still exhibit unfavorable short- and long-term prognoses. In addition, there is scant evidence about the clinical outcomes of patients with AMI and coronavirus disease 2019 (COVID-19). The objective of this study was to describe the clinical presentation, complications, and risk factors for mortality in patients admitted for AMI during the COVID-19 pandemic. Methods This prospective, multicenter, cohort study included all consecutive patients with AMI who underwent coronary angiography in a 30-day period corresponding chronologically with the COVID-19 outbreak (March 15 to April 15, 2020). Clinical presentations and outcomes were compared between COVID-19 and non-COVID-19 patients. The effect of COVID-19 on mortality was assessed by propensity score matching and with a multivariate logistic regression model. Results In total, 187 patients were admitted for AMI, 111 with ST-segment elevation AMI and 76 with non-ST-segment elevation AMI. Of these, 32 (17%) were diagnosed with COVID-19. GRACE score, Killip-Kimball classification, and several inflammatory markers were significantly higher in COVID-19-positive patients. Total and cardiovascular mortality were also significantly higher in COVID-19-positive patients (25% vs 3.8% [P 140 (OR, 23.45; 95%CI, 2.52–62.51; P = .005) and COVID-19 (OR, 6.61; 95%CI, 1.82-24.43; P = .02) were independent predictors of in-hospital death. Conclusions During this pandemic, a high GRACE score and COVID-19 were independent risk factors associated with higher in-hospital mortality.
- Published
- 2020