High prevalence of COVID-19 in patients with myocardial infarction undergoing percutaneous coronary intervention
High prevalence of COVID-19 in patients with myocardial infarction undergoing percutaneous coronary intervention

High prevalence of COVID-19 in patients with myocardial infarction undergoing percutaneous coronary intervention

A team of scientists from Iran has recently estimated the incidence of coronavirus disease 2019 (COVID-19) in patients with myocardial infarction receiving a primary percutaneous coronary intervention. A significantly high incidence of COVID-19 has been observed among the study participants. The study is currently available at The research site* Preprint server.

Examination: Frequency of COVID-19 in patients with myocardial infarction treated with primary percutaneous coronary intervention. Image credit: Kateryna Kon / Shutterstock

Background

The COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has severely affected the global healthcare system with more than 461 million infections and over 6 million deaths globally. Although SARS-CoV-2 mainly causes respiratory infection, the virus has been shown to infect a wide range of organs, including the gastrointestinal tract, heart, brain, liver and kidneys.

A high incidence of cardiovascular disease, including myocardial infarction, arrhythmia, acute coronary syndrome, and thromboembolism, has been observed in COVID-19 patients. In addition, in some COVID-19 patients, a higher incidence of cardiac symptoms has been identified compared to common respiratory symptoms. It is important that a significant association has been established between the presence of cardiac symptoms and increased COVID-19-related mortality.

Percutaneous coronary intervention, a medical procedure to reopen coronary artery blockages and restore blood supply to the heart, is considered to be the best intervention to treat myocardial infarction with ST segment elevation. However, evidence suggests that the COVID-19 pandemic has adversely affected the timely application of reperfusion therapy to patients with myocardial infarction due to a significant reduction in cardiac catheterization laboratory activations.

In the current study, the researchers estimated the incidence of COVID-19 in patients with myocardial infarction who had undergone primary percutaneous coronary intervention.

Study design

A total of 85 myocardial infarction patients were included in the study. All patients underwent primary percutaneous coronary intervention between March and September 2020. SARS-CoV-2 infection was detected by reverse transcription-polymerase chain reaction (RT-PCR) and lung CT scan. In addition, patients’ demographic characteristics (age, gender, and ethnicity) and comorbidities (diabetes and hypertension) were recorded at the time of admission.

Important observations

About 16.5% of myocardial infarction patients (14 out of 85 patients) were diagnosed with COVID-19. No significant difference in age and sex was observed between patients with and without COVID-19. In both groups (patients with and without COVID-19), the proportion of male patients was higher than female patients.

The study population involved different ethnicities, including Persians, Turkmens, Sistani, and Turks. However, no significant variation in ethnicity was observed between myocardial infarction patients with and without COVID-19.

The presence of hypertension and diabetes was detected in 9% and 10% of myocardial infarction patients, respectively. However, no significant difference in the frequency of these comorbidities was observed between patients with and without COVID-19.

Characterization of myocardial infarction patients with COVID-19

All myocardial infarction patients with COVID-19 (n = 14) tested positive for troponin I (a protein found in the heart muscle). The presence of troponin I in the blood indicates heart damage.

In 20% of the study population with COVID-19, a primary percutaneous coronary intervention was performed in the right coronary artery. Recurrence of myocardial infarction was observed in 14% of patients with COVID-19.

Only one patient died during the study period. The patient was a 70-year-old Persian woman with acute anterior myocardial infarction. She had both high blood pressure and diabetes. The primary percutaneous coronary intervention was performed on her left arterial descending coronary branch. However, the researchers could not confirm whether the death was due to myocardial infarction or COVID-19-related cardiovascular complications.

The significance of the study

The study reveals a significantly high prevalence (16.5%) of COVID-19 in patients with myocardial infarction receiving primary percutaneous coronary intervention. In addition, the study indicates that the presence of comorbidities, including hypertension and diabetes, may increase the risk of severe COVID-19 and related mortality in patients with myocardial infarction.

*Important message

The research site publishes preliminary scientific reports that are not peer-reviewed and therefore should not be considered essential, guide clinical practice / health-related behavior or be treated as established information.

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