Abstract 14246: Impact of Coronavirus Disease 2019 Infection on Non-ST Elevation Myocardial Infarction Outcomes

Abstract

Introduction: In this study, we explore the in-hospital outcomes of non-ST elevation myocardial infarction (NSTEMI) patients with and without concurrent coronavirus disease 2019 (COVID-19) infection. Methods: We utilized the National Inpatient Sample database (2016-2020) to identify patients who were admitted with a principal diagnosis of NSTEMI and a secondary diagnosis of COVID-19 infection. We conducted propensity score matching. Multivariable logistic regression, adjusted for age, sex and comorbidities, was used to compare mortality. Results: 1340 patients met our inclusion criteria. NSTEMI patients with concomitant COVID-19 infection had 3.24 times higher odds of suffering in-hospital mortality compared to NSTEMI admissions without COVID-19 (aOR 3.24, 95% CI: 1.93-5.43; p < 0.001). When separated by race, NSTEMI patients with COVID-19 had higher mortality rates amongst White (8.2% vs 4.7%, p = 0.04) and Black patients (14.2% vs 0.9%, p < 0.001, Figure 1). NSTEMI patients with COVID-19 infection were more likely to have acute respiratory distress syndrome (1.6% vs 0.1%, p = 0.004), myocarditis (1.3% vs 0%, p = 0.003) and severe sepsis (2.8% vs 0.9%, p = 0.01, Table 1). These patients were less likely to undergo percutaneous coronary intervention (PCI) (22.7% vs 28.4%, p = 0.02), but there was no significant difference in mean time to PCI (1.7 days vs 1.3 days, p = 0.12). Conclusion: Patients with NSTEMI and concurrent COVID-19 infection had higher odds of suffering in-hospital mortality compared to NSTEMI patients without COVID-19 infection. Further research should examine the impact of COVID-19 vaccination on the outcomes of this high-risk patient population.