Indian Heart Journal (Jul 2023)

COVID-19 infected ST-Elevation myocardial infarction in India (COSTA INDIA)

  • Abdullakutty Jabir,
  • Geevar Zachariah,
  • Padinhare Purayil Mohanan,
  • Mohit Dayal Gupta,
  • Sivasubramanian Ramakrishnan,
  • Chandra Bhan Meena,
  • L. Sridhar,
  • Meennahalli Palleda Girish,
  • Dipak Ranjan Das,
  • Anshul Gupta,
  • Praveen Nagula,
  • Tom Devasia,
  • Bhavesh Vajifdar,
  • Kamlesh Thakkar,
  • Urmil Shah,
  • Tanuj Bhatia,
  • Smit Srivastava,
  • Sanjeev Sharma,
  • Priya Kubendiran,
  • Pathiyil Balagopalan Jayagopal,
  • Sudeep Kumar,
  • Deepthy Sadanandan,
  • Lincy Mathew,
  • Nitish Naik,
  • Anup Banerji,
  • S.M. Ashraf,
  • P.K. Asokan,
  • Bishwa Bhushan Bharti,
  • Biswajit Majumder,
  • Dhiman Kahali,
  • Dhurjati Prasad Sinha,
  • Dipak Sharma,
  • Dipankar Ghosh Dastidar,
  • Dipankar Mukhapdhyay,
  • Gurpreet Sing Wander,
  • Harinder Kumar Bali,
  • B. Kesavamoorthy,
  • Manoj Kumar Agarwala,
  • Narendra Nath Khanna,
  • B.H. Natesh,
  • Pravin K. Goel,
  • Rabindra Nath Chakraborty,
  • Rajendra Kumar Jain,
  • Rakesh Yadav,
  • L. Sameer Dani,
  • Satyavan Sharma,
  • Satyendra Tewari,
  • K.K. Sethi,
  • Sharad Chandra,
  • Subrato Mandal,
  • Suman Bhandari,
  • Sundandan Sikdar,
  • Vivek Gupta,
  • Pratap Chandra Rath,
  • Vijay Harikisan Bang,
  • Debabrata Roy,
  • Mrinal Kanti Das,
  • Partho Sarathi Banerjee

Journal volume & issue
Vol. 75, no. 4
pp. 243 – 250

Abstract

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Objective: To find out differences in the presentation, management and outcomes of COVID-19 infected STEMI patients compared to age and sex-matched non-infected STEMI patients treated during the same period. Methods: This was a retrospective multicentre observational registry in which we collected data of COVID-19 positive STEMI patients from selected tertiary care hospitals across India. For every COVID-19 positive STEMI patient, two age and sex-matched COVID-19 negative STEMI patients were enrolled as control. The primary endpoint was a composite of in-hospital mortality, re-infarction, heart failure, and stroke. Results: 410 COVID-19 positive STEMI cases were compared with 799 COVID-19 negative STEMI cases. The composite of death/reinfarction/stroke/heart failure was significantly higher among the COVID-19 positive STEMI patients compared with COVID-19 negative STEMI cases (27.1% vs 20.7% p value = 0.01); though mortality rate did not differ significantly (8.0% vs 5.8% p value = 0.13). Significantly lower proportion of COVID-19 positive STEMI patients received reperfusion treatment and primary PCI (60.7% vs 71.1% p value=< 0.001 and 15.4% vs 23.4% p value = 0.001 respectively). Rate of systematic early PCI (pharmaco-invasive treatment) was significantly lower in the COVID-19 positive group compared with COVID-19 negative group. There was no difference in the prevalence of high thrombus burden (14.5% and 12.0% p value = 0.55 among COVID-19 positive and negative patients respectively) Conclusions: In this large registry of STEMI patients, we did not find significant excess in in-hospital mortality among COVID-19 co-infected patients compared with non-infected patients despite lower rate of primary PCI and reperfusion treatment, though composite of in-hospital mortality, re-infarction, stroke and heart failure was higher.

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