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Jabir A, Geevar Zachariah, Mohanan PP, Gupta MD, Ramakrishnan S, Meena CB, Sridhar L, Girish MP, Das DR, Gupta A, Praveen Nagula, Tom Devasia, Bhavesh Vajifdar, Kamlesh Thakkar, Urmil Shah, Tanuj Bhatia, Smit Srivastava, Sanjeev Sharma, Priya Kubendiran, Jayagopal PB, Sudeep Kumar, Deepthy Sadanandan, Lincy Mathew, Nitish Naik, Anup Banerji, Ashraf SM, Asokan PK, Bharti BB, Majumder B, Dhiman Kahali, Sinha DP, Sharma D, Dastidar DG, Dipankar Mukhapdhyay, Wander GS, Bali HK, Kesavamoorthy B, Agarwala MK, Khanna NN, Natesh BH, Goel PK, Chakraborty RN, Jain RK, Rakesh Yadav, Sameer Dani L, Satyavan Sharma, Satyendra Tewari, Sethi KK, Sharad Chandra, Mandal S, Bhandari S, Sikdar S, Vivek Gupta, Rath PC, Bang VH, Debabrata Roy, Das MK, Banerjee PS. COVID-19 infected ST-Elevation myocardial infarction in India (COSTA INDIA). Indian Heart J 2023; 75:243-250. [PMID: 37230465 PMCID: PMC10204278 DOI: 10.1016/j.ihj.2023.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 05/09/2023] [Accepted: 05/21/2023] [Indexed: 05/27/2023] Open
Abstract
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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Affiliation(s)
| | | | | | | | | | | | - L Sridhar
- Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bangalore, Karnataka, India.
| | | | | | | | | | - Tom Devasia
- Kasturba Medical College Manipal, Karnataka, India.
| | - Bhavesh Vajifdar
- Lilavati Hospital and Research Centre, Mumbai, Maharashtra, India
| | | | | | | | - Smit Srivastava
- Dr Bhim Rao Ambedhkar Memorial Hospital, Raipur, Chhattisgarh, India.
| | | | - Priya Kubendiran
- G Kuppuswamy Naidu Memorial Hospital, Coimbatore, Tamil Nadu, India.
| | | | - Sudeep Kumar
- Sanjay Gandhi Postgraduate of Medical Sciences, Lucknow, Uttar Pradesh, India.
| | | | | | - Nitish Naik
- All India Institute of Medical Sciences, Delhi, India.
| | - Anup Banerji
- Medica Superspeciality Hospital, Kolkata, West Bengal, India.
| | - S M Ashraf
- Government Medical College, Kannur, Kerala, India.
| | - P K Asokan
- Fathima Hospital, Kozhikode, Kerala, India.
| | | | | | - Dhiman Kahali
- B M Birla Heart Research Centre, Kolkata, West Bengal, India.
| | | | - Dipak Sharma
- Christian Medical Centre Hospital, Jorht, Assam, India.
| | | | | | | | | | - B Kesavamoorthy
- Meenakshi Multispeciality Hospital, Trichy, Tamil Nadu, India.
| | | | | | - B H Natesh
- Sri Jayadeva Institute of Cardiovascular Science and Research, Bengaluru, Karnataka, India.
| | | | | | | | | | - L Sameer Dani
- Apollo CVHF Heart Institute, Ahmedabad, Gujarat, India.
| | | | - Satyendra Tewari
- Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
| | - K K Sethi
- Delhi Heart and Lung Institute, New Delhi, India.
| | - Sharad Chandra
- King George Medical University, Lucknow, Uttar Pradesh, India.
| | - Subrato Mandal
- Ubuntu Heart and Superspeciality Hospital, Bhopal, Madhya Pradesh, India.
| | | | | | | | | | | | - Debabrata Roy
- N H Rabindranatha Tagore International Institute of Cardiac Sciences, Kolkata, West Bengal, India.
| | - Mrinal Kanti Das
- The Calcutta Medical Research Institute, Kolkata, West Bengal, India.
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