ST Segment Elevated Myocardial Infarction Associated with High Mortality and Thrombus Burden in Patients with COVID-19 Infection

INTRODUCTION: There is limited information regarding the clinical and angiographic characteristics and outcomes of patients with Coronavirus disease 2019 (COVID-19) presenting with ST segment elevation myocardial infarction (STEMI). The aim of this study was to describe the clinical and angiographic characteristics, as well as clinical outcomes, in COVID-19 positive patients with STEMI compared with COVID-19 negative STEMI patients.
METHODS: This was a single-center observational study conducted between May 2020 and May 2021. The study population consisted of 35 patients who were followed with active COVID-19 and diagnosed with STEMI, and 35 STEMI patients without COVID-19 infection.
RESULTS: Groups were similar in terms of gender, hypertension, obstructive airway disease, SYNTAX score, and localization of myocardial infarction (MI). Glucose levels, BUN, creatinine, and CRP levels were significantly higher in the COVID-19 group. LDL and hemoglobin levels were lower in the COVID-19 group (p<0.05). There was a positive correlation between in-hospital death and modified thrombus grade post-first device and a negative correlation between in-hospital death and post-procedural TIMI flow (p=0.001, r=0.480).
DISCUSSION AND CONCLUSION: Our results demonstrate that patients presenting with STEMI and concurrent COVID-19 infection have a higher post-procedural thrombus burden and worse Thrombolysis in Myocardial Infarction (TIMI) flow. STEMI patients with COVID-19 face procedural challenges and are associated with poorer clinical outcomes.