Ahmad Abou Hamed, Maeva Gourraud, Thibaud Genet, François Barbier, Denis Angoulvant, Laurent Fauchier, Fabrice Ivanes
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引用次数: 0
Abstract
Background: The prognosis of patients with acute myocardial infarction (AMI) in the setting of coronavirus disease 2019 (COVID-19) remains uncertain.
Aims: To evaluate patients' prognosis after an AMI concomitant with COVID-19.
Methods: This retrospective nationwide observational cohort study was based on the French administrative hospital discharge database. Primary outcomes were incidences of all-cause death, cardiovascular death, heart failure (HF), recurrence of AMI, ischaemic stroke, incident atrial fibrillation (AF), ventricular tachycardia/ventricular fibrillation (VT/VF) and cardiac arrest. Patients with AMI and COVID-19 were matched to those without COVID-19 (using propensity score matching techniques) to account for differences between the two populations.
Results: A total of 288,408 patients hospitalized for AMI in France from March 2020 to January 2023 were included; 26,879 had a COVID-19-positive test between 15 days before to 5 days after admission. Patients with COVID-19 were older, more frequently had diabetes mellitus and obesity but less frequently smoked. They more frequently had non-ST-segment elevation myocardial infarction presentation and more often had lung disease. After matching, patients with COVID-19 had higher risks of all-cause death (hazard ratio [HR] 1.255; 95% confidence interval [CI] 1.203-1.308; P<0.0001), HF (HR 1.205; 95% CI 1.159-1.254; P<0.0001), ischaemic stroke (HR 1.237; 95% CI 1.084-1.411; P=0.002), incident AF (HR 1.160; 95% CI 1.070-1.258; P=0.0003) and VT/VF (1.360; 95% CI 1.200-1.540; P<0.0001). Surprisingly, cardiovascular death risk was lower in patients with COVID-19 (HR 0.932; 95% CI 0.879-0.988; P=0.02) as a result of competition with non-cardiovascular death. No statistical difference was found for cardiac arrest or recurrent AMI.
Conclusion: In this French nationwide cohort study, AMI in patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) increased all-cause death incidence compared to non-infected AMI, but this poorer prognosis was not due to cardiovascular death. Further investigations are needed to elucidate the aetiologies of death.
期刊介绍：
The Journal publishes original peer-reviewed clinical and research articles, epidemiological studies, new methodological clinical approaches, review articles and editorials. Topics covered include coronary artery and valve diseases, interventional and pediatric cardiology, cardiovascular surgery, cardiomyopathy and heart failure, arrhythmias and stimulation, cardiovascular imaging, vascular medicine and hypertension, epidemiology and risk factors, and large multicenter studies. Archives of Cardiovascular Diseases also publishes abstracts of papers presented at the annual sessions of the Journées Européennes de la Société Française de Cardiologie and the guidelines edited by the French Society of Cardiology.
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