Aleksandra D Milošević, Marija M Polovina, Dario D Jelic, Damjan D Simic, Mihajlo M Viduljevic, Dragan M Matic, Milenko M Tomic, Tatjana N Adzic, Milika R Asanin
{"title":"ST段抬高型心肌梗死发生时间与COVID-19感染的预后关系","authors":"Aleksandra D Milošević, Marija M Polovina, Dario D Jelic, Damjan D Simic, Mihajlo M Viduljevic, Dragan M Matic, Milenko M Tomic, Tatjana N Adzic, Milika R Asanin","doi":"10.1177/08850666241232938","DOIUrl":null,"url":null,"abstract":"<p><p><b>Background:</b> Patients with ST-segment elevation myocardial infarction (STEMI) and COVID-19 infection have a worse clinical course and prognosis. The prognostic significance of the timing of STEMI in relation to COVID-19 infection was not investigated. <b>Objectives:</b> To assess whether the time of STEMI development in relation to COVID-19 infection (concurrent or following the infection) influenced the short-term prognosis. <b>Methods:</b> This was an observational study of consecutive COVID-19 patients with STEMI admitted to the COVID-hospital Batajnica (February 2021-March 2022). The patients were divided into the \"STEMI first\" group: patients with STEMI and a positive polymerase chain reaction test for COVID-19, and the \"COVID-19 first\" group: patients who developed STEMI during COVID-19 treatment. All patients underwent coronary angiography. The primary endpoint was in-hospital all-cause mortality. <b>Results:</b> The study included 87 patients with STEMI and COVID-19 (<i>M</i><sub>age</sub>, 66.7 years, 66% male). The \"STEMI first\" group comprised 54 (62.1%) patients, and the \"COVID-19 first\" group included 33 (37.9%) patients. Both groups shared a comparatively high burden of comorbidities, similar angiographic and procedural characteristics, and high percentages of performed percutaneous coronary interventions with stent implantation (90.7% vs. 87.9%). In-hospital mortality was significantly higher in the \"COVID-19 first\" group compared to the \"STEMI first\" group (51.5% vs. 27.8%). Following adjustment, the \"COVID-19 first\" group had a hazard ratio of 3.22 (95% confidence interval, 1.18-8.75, <i>p</i> = .022) for in-hospital all-cause death, compared with the \"STEMI first\" group (reference). <b>Conclusion:</b> Clinical presentation with COVID-19 infection, followed by STEMI (\"COVID-19 first\"), was associated with greater short-term mortality compared to patients presenting with STEMI and testing positive for COVID-19 (\"STEMI first\").</p>","PeriodicalId":16307,"journal":{"name":"Journal of Intensive Care Medicine","volume":null,"pages":null},"PeriodicalIF":3.0000,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Prognostic Implications of the Timing of ST-Elevation Myocardial Infarction Development in Relation to COVID-19 Infection.\",\"authors\":\"Aleksandra D Milošević, Marija M Polovina, Dario D Jelic, Damjan D Simic, Mihajlo M Viduljevic, Dragan M Matic, Milenko M Tomic, Tatjana N Adzic, Milika R Asanin\",\"doi\":\"10.1177/08850666241232938\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b>Background:</b> Patients with ST-segment elevation myocardial infarction (STEMI) and COVID-19 infection have a worse clinical course and prognosis. The prognostic significance of the timing of STEMI in relation to COVID-19 infection was not investigated. <b>Objectives:</b> To assess whether the time of STEMI development in relation to COVID-19 infection (concurrent or following the infection) influenced the short-term prognosis. <b>Methods:</b> This was an observational study of consecutive COVID-19 patients with STEMI admitted to the COVID-hospital Batajnica (February 2021-March 2022). The patients were divided into the \\\"STEMI first\\\" group: patients with STEMI and a positive polymerase chain reaction test for COVID-19, and the \\\"COVID-19 first\\\" group: patients who developed STEMI during COVID-19 treatment. All patients underwent coronary angiography. The primary endpoint was in-hospital all-cause mortality. <b>Results:</b> The study included 87 patients with STEMI and COVID-19 (<i>M</i><sub>age</sub>, 66.7 years, 66% male). The \\\"STEMI first\\\" group comprised 54 (62.1%) patients, and the \\\"COVID-19 first\\\" group included 33 (37.9%) patients. Both groups shared a comparatively high burden of comorbidities, similar angiographic and procedural characteristics, and high percentages of performed percutaneous coronary interventions with stent implantation (90.7% vs. 87.9%). In-hospital mortality was significantly higher in the \\\"COVID-19 first\\\" group compared to the \\\"STEMI first\\\" group (51.5% vs. 27.8%). Following adjustment, the \\\"COVID-19 first\\\" group had a hazard ratio of 3.22 (95% confidence interval, 1.18-8.75, <i>p</i> = .022) for in-hospital all-cause death, compared with the \\\"STEMI first\\\" group (reference). <b>Conclusion:</b> Clinical presentation with COVID-19 infection, followed by STEMI (\\\"COVID-19 first\\\"), was associated with greater short-term mortality compared to patients presenting with STEMI and testing positive for COVID-19 (\\\"STEMI first\\\").</p>\",\"PeriodicalId\":16307,\"journal\":{\"name\":\"Journal of Intensive Care Medicine\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.0000,\"publicationDate\":\"2024-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Intensive Care Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/08850666241232938\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/2/19 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"CRITICAL CARE MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Intensive Care Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/08850666241232938","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/2/19 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"CRITICAL CARE MEDICINE","Score":null,"Total":0}
Prognostic Implications of the Timing of ST-Elevation Myocardial Infarction Development in Relation to COVID-19 Infection.
Background: Patients with ST-segment elevation myocardial infarction (STEMI) and COVID-19 infection have a worse clinical course and prognosis. The prognostic significance of the timing of STEMI in relation to COVID-19 infection was not investigated. Objectives: To assess whether the time of STEMI development in relation to COVID-19 infection (concurrent or following the infection) influenced the short-term prognosis. Methods: This was an observational study of consecutive COVID-19 patients with STEMI admitted to the COVID-hospital Batajnica (February 2021-March 2022). The patients were divided into the "STEMI first" group: patients with STEMI and a positive polymerase chain reaction test for COVID-19, and the "COVID-19 first" group: patients who developed STEMI during COVID-19 treatment. All patients underwent coronary angiography. The primary endpoint was in-hospital all-cause mortality. Results: The study included 87 patients with STEMI and COVID-19 (Mage, 66.7 years, 66% male). The "STEMI first" group comprised 54 (62.1%) patients, and the "COVID-19 first" group included 33 (37.9%) patients. Both groups shared a comparatively high burden of comorbidities, similar angiographic and procedural characteristics, and high percentages of performed percutaneous coronary interventions with stent implantation (90.7% vs. 87.9%). In-hospital mortality was significantly higher in the "COVID-19 first" group compared to the "STEMI first" group (51.5% vs. 27.8%). Following adjustment, the "COVID-19 first" group had a hazard ratio of 3.22 (95% confidence interval, 1.18-8.75, p = .022) for in-hospital all-cause death, compared with the "STEMI first" group (reference). Conclusion: Clinical presentation with COVID-19 infection, followed by STEMI ("COVID-19 first"), was associated with greater short-term mortality compared to patients presenting with STEMI and testing positive for COVID-19 ("STEMI first").
期刊介绍:
Journal of Intensive Care Medicine (JIC) is a peer-reviewed bi-monthly journal offering medical and surgical clinicians in adult and pediatric intensive care state-of-the-art, broad-based analytic reviews and updates, original articles, reports of large clinical series, techniques and procedures, topic-specific electronic resources, book reviews, and editorials on all aspects of intensive/critical/coronary care.