Outcomes Among ST-Elevation Myocardial Infarction (STEMI) Patients with Cardiogenic Shock and COVID-19: A Nationwide Analysis
Background: There is paucity of data regarding the characteristics and outcomes of patients admitted for ST Elevation Myocardial Infarction (STEMI) complicated by cardiogenic shock (CS) with concomitant Coronavirus Disease 2019 (COVID-19) infection.
Methods: Using the National Inpatient Sample (NIS) Database for the year 2020, we conducted a retrospective cohort study to investigate the outcomes of patients who sustained STEMI-associated cardiogenic shock (STEMI-CS) with concomitant COVID-19 infection looking at its impact on in-hospital mortality and secondarily at the in-hospital procedure and intervention utilization rates as well as hospital length of stay.
Results: We identified a total of 22,775 patients with STEMI-CS, of which 1.71 % (n = 390/22,775) had COVID-19 infection. Using a stepwise survey multivariable logistic regression model that adjusted for patient and hospital level confounders, concomitant COVID-19 infection among STEMI-CS patients was found to be an independent predictor of overall in-hospital mortality compared to those without COVID-19 (adjusted OR 2.10; 95 % confidence interval [CI], 1.30-3.40). STEMI-CS patients with concomitant COVID-19 infection had similar in-hospital utilization rates for percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG), extracorporeal membrane oxygenation (ECMO), percutaneous and durable left ventricular device, intra-arterial aortic balloon pump (IABP), renal replacement therapy (RRT), mechanical ventilation, as well as similar hospital lengths of stay.
Conclusion: Concomitant COVID-19 infection was associated with higher in-hospital mortality rates among patients with cardiogenic shock related to STEMI but had similar in-hospital procedure and intervention utilization rates as well as hospital length of stay.
Casipit, Bruce Adrian; Azmaiparashvili, Zurab; Lo, Kevin Bryan; and Amanullah, Aman, "Outcomes Among ST-Elevation Myocardial Infarction (STEMI) Patients with Cardiogenic Shock and COVID-19: A Nationwide Analysis" (2023). Division of Cardiology Faculty Papers. Paper 121.
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This article is the author’s final published version in American Heart Journal Plus: Cardiology Research and Practice, Volume 25, January 2023, Article number 100243.
The published version is available at https://doi.org/10.1016/j.ahjo.2022.100243. Copyright © Casipit et al.