Initial Findings From the North American COVID-19 Myocardial Infarction Registry.

Apr 26, 2021

Contributor: Santiago Garcia,Payam Dehghani,Cindy Grines,Laura Davidson,Keshav R Nayak,Jacqueline Saw,Ron Waksman,John Blair,Bagai Akshay,Ross Garberich,Christian Schmidt,Hung Q Ly,Scott Sharkey,Nestor Mercado,Carlos E Alfonso,Naoki Misumida,Deepak Acharya,Mina Madan,Abdul Moiz Hafiz,Nosheen Javed,Jay Shavadia,Jay Stone,M Chadi Alraies,Wah Htun,William Downey,Brian A Bergmark,Jospeh Ebinger,Tareq Alyousef,Houman Khalili,Chao-Wei Hwang,Joshua Purow,Alexander Llanos,Brent McGrath,Mark Tannenbaum,Jon Resar,Rodrigo Bagur,Pedro Cox-Alomar,Ada C Stefanescu Schmidt,Lindsey A Cilia,Farouc A Jaffer,Michael Gharacholou,Michael Salinger,Brian Case,Ameer Kabour,Xuming Dai,Osama Elkhateeb,Taisei Kobayashi,Hahn-Ho Kim,Mazen Roumia,Frank V Aguirre,Jeffrey Rade,Aun-Yeong Chong,Hurst M Hall,Shy Amlani,Alireza Bagherli,Rajan A G Patel,David A Wood,Frederick G Welt,Jay Giri,Ehtisham Mahmud,Timothy D Henry,

Initial Findings From the North American COVID-19 Myocardial Infarction Registry.

The coronavirus disease 2019 (COVID-19) pandemic has impacted many aspects of ST-segment elevation myocardial infarction (STEMI) care, including timely access to primary percutaneous coronary intervention (PPCI).
The goal of the NACMI (North American COVID-19 and STEMI) registry is to describe demographic characteristics, management strategies, and outcomes of COVID-19 patients with STEMI.
A prospective, ongoing observational registry was created under the guidance of 3 cardiology societies. STEMI patients with confirmed COVID+ (group 1) or suspected (person under investigation [PUI]) (group 2) COVID-19 infection were included. A group of age- and sex-matched STEMI patients (matched to COVID+ patients in a 2:1 ratio) treated in the pre-COVID era (2015 to 2019) serves as the control group for comparison of treatment strategies and outcomes (group 3). The primary outcome was a composite of in-hospital death, stroke, recurrent myocardial infarction, or repeat unplanned revascularization.
As of December 6, 2020, 1,185 patients were included in the NACMI registry (230 COVID+ patients, 495 PUIs, and 460 control patients). COVID+ patients were more likely to have minority ethnicity (Hispanic 23%, Black 24%) and had a higher prevalence of diabetes mellitus (46%) (all p < 0.001 relative to PUIs). COVID+ patients were more likely to present with cardiogenic shock (18%) but were less likely to receive invasive angiography (78%) (all p < 0.001 relative to control patients). Among COVID+ patients who received angiography, 71% received PPCI and 20% received medical therapy (both p < 0.001 relative to control patients). The primary outcome occurred in 36% of COVID+ patients, 13% of PUIs, and 5% of control patients (p < 0.001 relative to control patients).
COVID+ patients with STEMI represent a high-risk group of patients with unique demographic and clinical characteristics. PPCI is feasible and remains the predominant reperfusion strategy, supporting current recommendations.

Copyright © 2021 American College of Cardiology Foundation. All rights reserved.

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About The Expert

Santiago Garcia

Minneapolis Heart Institute Foundation. Minneapolis, Minnesota, USA. Electronic address: santiagogarcia@me.com.

Payam Dehghani

Prairie Vascular Research, Regina, Saskatchewan, Canada.

Cindy Grines

Northside Cardiovascular Institute, Atlanta, Georgia, USA; Society for Cardiovascular Angiography and Interventions, Washington, DC, USA.

Laura Davidson

Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.

Keshav R Nayak

Department of Cardiology, Scripps Mercy Hospital, San Diego, California, USA.

Jacqueline Saw

Vancouver General Hospital, Vancouver, British Columbia, Canada.

Ron Waksman

MedStar Washington Hospital Center, Washington, DC, USA.

John Blair

University of Chicago, Chicago, Illinois, USA.

Bagai Akshay

St. Michael’s Hospital, Toronto, Ontario, Canada.

Ross Garberich

Minneapolis Heart Institute Foundation. Minneapolis, Minnesota, USA.

Christian Schmidt

Minneapolis Heart Institute Foundation. Minneapolis, Minnesota, USA.

Hung Q Ly

University of Montreal, Montreal, Quebec, Canada.

Scott Sharkey

Minneapolis Heart Institute Foundation. Minneapolis, Minnesota, USA.

Nestor Mercado

University of New Mexico, Albuquerque, New Mexico, USA.

Carlos E Alfonso

University of Miami, Miami, Florida, USA.

Naoki Misumida

University of Kentucky, Lexington, Kentucky, USA.

Deepak Acharya

University of Arizona Sarver Heart Center, Tucson, Arizona, USA.

Mina Madan

Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.

Abdul Moiz Hafiz

Southern Illinois University School of Medicine, Springfield, Illinois, USA.

Nosheen Javed

Southcoast Health System, New Bedford, Massachusetts, USA.

Jay Shavadia

Royal University Hospital, Saskatchewan Health, Saskatoon, Saskatchewan, Canada.

Jay Stone

Community Medical Center, RWJ Barnabas Health, Toms River, New Jersey, USA.

M Chadi Alraies

DMC Harper University Hospital, Detroit, Michigan, USA.

Wah Htun

Gundersen Health System, La Crosse, Wisconsin, USA.

William Downey

Sanger Heart and Vascular Institute, Atrium Health, Charlotte, North Carolina, USA.

Brian A Bergmark

TIMI Study Group, Brigham and Women’s Hospital, Boston, Massachusetts, USA.

Jospeh Ebinger

Cedars Sinai Heart Institute, Los Angeles, California, USA.

Tareq Alyousef

Cook County Health and Hospitals System, Chicago, Illinois, USA.

Houman Khalili

Delray Medical Center, Tenet Healthcare, Delray Beach, Florida, USA.

Chao-Wei Hwang

Frederick Health Hospital, Frederick, Maryland, USA; Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

Joshua Purow

Holy Cross Hospital, Fort Lauderdale, Florida, USA.

Alexander Llanos

Holy Cross Hospital, Fort Lauderdale, Florida, USA.

Brent McGrath

Horizon Health Network, Saint John, New Brunswick, Canada.

Mark Tannenbaum

Iowa Heart, West Des Moines, Iowa, USA.

Jon Resar

Frederick Health Hospital, Frederick, Maryland, USA, and Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

Rodrigo Bagur

London Health Sciences Centre, Western University, London, Ontario, Canada.

Pedro Cox-Alomar

Louisiana State University, New Orleans, Louisiana, USA.

Ada C Stefanescu Schmidt

Massachusetts General Hospital, Boston, Massachusetts, USA.

Lindsey A Cilia

Massachusetts General Hospital, Boston, Massachusetts, USA.

Farouc A Jaffer

Massachusetts General Hospital, Boston, Massachusetts, USA.

Michael Gharacholou

Mayo Clinic Jacksonville, Jacksonville, Florida, USA.

Michael Salinger

Medical College of Wisconsin, Wauwatosa, Wisconsin, USA.

Brian Case

MedStar Washington Hospital Center, Washington, DC, USA.

Ameer Kabour

Mercy St. Vincent’s Medical Center, Toledo, Ohio, USA.

Xuming Dai

NewYork-Presbyterian Queens, Flushing, New York, USA.

Osama Elkhateeb

Nova Scotia Health, Halifax, Nova Scotia, Canada.

Taisei Kobayashi

University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Hahn-Ho Kim

St. Mary’s General Hospital, Kitchener, Ontario, Canada.

Mazen Roumia

St. Vincent Hospital, Worcester, Massachusetts, USA.

Frank V Aguirre

Prairie Heart Institute at HSHS St. John’s Hospital, Springfield, Illinois, USA.

Jeffrey Rade

UMass Memorial Medical Center, Worcester, Massachusetts, USA.

Aun-Yeong Chong

University of Ottawa Heart Institute, Ottawa, Ontario, Canada.

Hurst M Hall

UT Southwestern Medical Center, Dallas, Texas, USA.

Shy Amlani

William Osler Health System, Brampton, Ontario, Canada.

Alireza Bagherli

Windsor Regional Hospital, Windsor, Ontario, Canada.

Rajan A G Patel

Ochsner Medical Center, New Orleans, Louisiana, USA.

David A Wood

Canadian Association of Interventional Cardiology, Ottawa, Ontario, Canada.

Frederick G Welt

American College of Cardiology Interventional Cardiology Section Leadership Council, Washington, DC, USA; University of Utah Health Sciences, Salt Lake City, Utah, USA.

Jay Giri

University of Pennsylvania, Philadelphia, Pennsylvania, USA. Electronic address: https://twitter.com/jaygirimd.

Ehtisham Mahmud

Sulpizio Cardiovascular Center, University of California San Diego, La Jolla, California, USA.

Timothy D Henry

Carl and Edyth Lindner Center for Research and Education, the Christ Hospital, Cincinnati, Ohio, USA. Electronic address: https://twitter.com/HenrytTimothy.

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Initial Findings From the North American COVID-19 Myocardial Infarction Registry.

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About The Expert

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