Acute coronary syndrome in COVID-19 patients. Clinical features, severity and outcomes. Results from Spanish multicenter registry Car-COVID19

Abstract

Funding AcknowledgementsType of funding sources: Foundation. Main funding source(s): Fundación del CorazónIntroductionCOVID19 has spread uncontrollably all over the world through this 2020 year. As a new entity, we did not know the potential cardiovascular manifestations of this infectious disease. This national registry was created to describe the cardiac affection and its severity.Methods and resultsA multicenter registry was conducted, including 28 centers in Spain. Patients with COVID19 diagnosis presenting an acute cardiovascular event between March 1st and May 30th were included. Eighty-two patients were included. Of them, 49 (76,6%) presented with acute coronary syndrome; the rest were diagnosed of acute myocarditis or stress cardiomyopathy. The majority of cases were STEMI (n = 31), while the remaining 35,4% presented as NSTEMI. 29 patients (61,7%) underwent emergent percutaneous coronary intervention (PCI) (Figure 1). Anterior (n = 18) and inferior (n = 16) were the most frequent locations. Coronary angiogram showed total occlusion in 20 patients (55,6%); while 7 patients presented with non-obstructive coronary arteries. PCI was done in 31 patients.Eight patients (17,8%) developed Killip III-IV myocardial infarction. A total of 10 patients required endotracheal intubation and vasoactive agent were needed in 11 patients; none required IABP or ECMO. In-hospital mortality rate was 26,2%.ConclusionsPatients with COVID19 may present with acute coronary syndromes. This entity has a poor prognosis, with noteworthy mortality. Table 1. Baseline characteristics.n (%)Age69,0[63,0-76,5]Sex (female)9 (19,1%)Hypertension28 (57,1%)Dyslipidemia25 (51,0%)Diabetes mellitus11 (22,4%)Chronic coronary disease10 (20,4%)Previous PCI10 (20,4%)Previous CABG0Previous AAS15 (30,6%)Smoking10 (20,4%)PCI percutaneous coronary intervention; CABG: coronary artery bypass graft; AAS: aspirin. Figure 1.