Severe Acute Respiratory Syndrome Coronavirus 2 Antibodies in ST-segment Elevation Myocardial Infarction Patients and its Impact on Thrombus in the Coronaries

Abstract

Objective: Higher thrombus load and poorer outcomes have been reported in coronavirus disease 2019 (COVID-19) patients with ST-segment elevation myocardial infarction (STEMI). The presence of antibodies to the COVID-19 infection has been linked to excess thrombus. This retrospective study compared the thrombus burden and outcomes in STEMI during primary angioplasty in myocardial infarction (PAMI) between the two groups with Sars antibody positive (SAP) and Sars antibody negative (SAN). Materials and Methods: Consecutive STEMI patients undergoing PAMI from November 2020 to July 2021 admitted to this single center were included. All patients were ruled out for an active infection by a negative rapid antigen and subsequently by reverse transcription polymerase chain reaction test. Participants were divided into SAP and SAN groups based on COVID-19 antibody results performed with the Roche kit. The primary aim was to compare thrombus load, coronary risk factors, and demographic characteristics between SAP and SAN patients and the secondary aim was to compare the inhospital and 30-day mortality between the two groups after primary percutaneous coronary intervention (PPCI). Results: The study included 261 consecutive STEMI patients (≥18 years; average age: 60.32 + 11.5 [standard deviation]). COVID antibody test results were available for 177 patients (36 SAP and 141 SAN), and these patients were included in the analysis; 144 were male, and 33 were female. There was no significant difference in baseline demographic characteristics between the two groups. Inflammatory markers, such as C-reactive protein (P = 0.479), troponin-T (P = 0.466), or D-dimer (P = 0.681) levels, and thrombus load status (G0 to G5) were not statistically significantly different (P = 0.344) between the two groups. Two patients in the SAP group and none in the SAN group (P = 0.005) died. The 30-day mortality rate (one patient in each group; P = 0.272) was not statistically significantly different between the two groups. Conclusion: Positive COVID-19 antibody levels in the blood did not produce changes in thrombus load and presentation in STEMI PAMI patients. The inhospital mortality rates and 30-day mortality rates were not affected by the antibody levels to COVID-19 infection.