ST-segment Elevation Myocardial Infarction Research Articles

A comparison of the effects of ticagrelor and clopidogrel in patients with acute ST-segment elevation myocardial infarction: a systematic review and meta-analysis of randomized clinical trials

BackgroundRupture of unstable coronary atherosclerotic plaque leads to acute ST-segment elevation myocardial infarction (STEMI). Dual anti-platelet therapy is one of the main treatments, and the combination of Aspirin and Clopidogrel is recognized as the standard oral regimen in most cases. Ticagrelor is a new generation of P2Y12 receptor inhibitors. We aimed to compare the effect of Ticagrelor and Clopidogrel in the treatment of patients post-STEMI.MethodsThis study investigated Pub Med, Scopus, Google Scholar Web of Science, and Embase Cochrane Library clinical trials.gov databases. Heterogeneity between studies was assessed using the I2 index and the Q statistic. The random effects model was used to combine studies and the Funnel plot and Egger’s test were used to assess the publication bias.ResultsEleven studies were included in this meta-analysis. 5274 patients in the Ticagrelor and 5,295 patients in the Clopidogrel groups were examined. The mean age of the patients was 58.84 years (2.70) and 59.92 years (3.19) in the Ticagrelor and Clopidogrel groups, respectively. Based on the results of the meta-analysis, compared to Clopidogrel, Ticagrelor had decreased the outcomes of mortality, recurrent myocardial infarction, stroke, and Major Adverse Cardiovascular Events (MACE). However, the post-myocardial infarction bleeding according to Bleeding Academic Research Consortium (BARC) criteria and reperfusion state regarding thrombolysis in myocardial infarction (TIMI) Flow Grading system showed no differences in both groups. However, these effects were not statistically significant.ConclusionsTicagrelor decreased the chance of mortality, re-infarction, stroke, and MACE in post-STEMI patients compared to clopidogrel. But there was no difference in the chance of major bleedings (BARC ≥ 3) and improvement in TIMI grade flow between these two drugs. However, none of these findings were statistically significant, and more studies are needed to reach definitive results.

Acute Aortic Dissection Complicating Emergency Coronary Intervention for Hyperacute Stent Thrombosis

Introduction: Iatrogenic acute aortic dissection resulting from coronary interventions can have fatal consequences. Although it is an uncommon complication during percutaneous coronary interventions (PCI), it can arise from various factors. Our case report aims to address this rare presentation further, seeking to enhance preprocedural planning which can result in better outcomes. Case Report: We describe an intriguing case of an elderly female patient with multiple cardiovascular risk factors who came to our emergency department presenting with chest pain. Her Electrocardiogram revealed an inferior ST-elevation myocardial infarction (STEMI) for which she underwent successful primary PCI of the right coronary artery (RCA). Four days later, she had an infero-posterior STEMI, which necessitated immediate coronary angiography. Angiography revealed thrombosis of the stent placed earlier in the RCA. On attempting recanalization of the vessel, an acute aortic dissection was identified and was successfully managed by ostial stenting. Follow-up imaging showed no residual dissection, and the patient was found to be comfortable and stable post-procedure. Conclusion: We recommend optimizing blood pressure and performing rapid ostial stenting in these cases, irrespective of the dissection’s origin. This will facilitate effective sealing of the entry site and prevent further progression of the dissection. Our report highlights the favorable results achieved with immediate ostial stenting while discussing the conservative approach to managing such cases.

Exploring the morphine-platelet activity association in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention

ST-segment elevation myocardial infarction (STEMI) is usually caused by a ruptured atherosclerotic plaque, with subsequent thrombus formation. Platelet inhibition and primary percutaneous coronary intervention (PCI) are essential treatments. Morphine, used to relieve pain and anxiety in STEMI patients, delays the onset of P2Y12 inhibitors. This study aimed to further explore the association between platelet activity and morphine treatment in patients with STEMI. In this sub-study of the VALIDATE-SWEDHEART trial, 89 STEMI patients treated with ticagrelor, and primary PCI were included. Platelet aggregation and biomarkers of platelet activity, coagulation, and inflammation (sP-selectin, thrombin-antithrombin complexes, prothrombin fragments 1 + 2, CD40L, CRP, beta-thromboglobulin, and pentraxin3) were assessed at three time points: before, one, and twelve hours after PCI. Of the 89 patients, 40 received morphine before hospital arrival. There were no significant differences in age, sex, medical history, or coronary disease extent. One hour after PCI, ADP-induced (36 vs 61, p < .001), arachidonic acid-induced (20 vs 36, p = .003), collagen-induced (48 vs 60, p = .03) aggregation, and the proportion of high on-treatment ADP-induced platelet reactivity (27% vs 60%, p = .001) were significantly higher in morphine-treated patients. No significant differences were found before or 12 hours after PCI. No significant differences in platelet activity biomarkers were observed. Morphine increased platelet aggregation in STEMI patients but did not affect biomarkers.

Focus ultrasound in patients with ST-elevation myocardial infarction during initial physical examination

Background. The generally algorithm for the initial physical examination of patients with STEMI, including medical history and ECG, is inadequate. Short focal ultrasound protocols can improve the diagnostic accuracy of the initial physical examination, but when they are needed, there are currently no clear and understandable algorithms. Objective. Evaluate the impact of routine focal ultrasound on the initial physical examination of STEMI patients. Material and methods. A total of 228 patients with STEMI were included in a single-center prospective cohort study. The patients will be enrolled at the I.V. Davydovsky Moscow City Clinical Hospital from 2019 to 2023. Results. The main group consisted of 126 patients undergoing routine focal ultrasound, the control group 102 patients with standard physical examination algorithm. The primary endpoint including door-to-instrument time was better in the study group compared to the control group (Me [Q1–Q3], 30 [27–37] vs. 37 [31.5–45] minutes, p &lt; 0.001). The advantage was achieved by a shorter Cath lab-to-instrument time in the study group (Me [Q1-Q3], 10 [10–15] vs. 15 [15–25] minutes, p &lt; 0.001). The secondary endpoint was the probability of a change in diagnosis, which did not differ between groups at the initial examination (abs (%), 24 (19%) vs. 25 (24.5%), p = 0.318), but occurred more frequently after invasive angiography in the control group (abs (%), 15 (11.9%) vs. 24 (23.5), p = 0.036). The detection of significant cardiac pathology during initial physical examination was higher in the main group (abs (%), 87 (69.0%) versus 24 (23.5), p&lt; 0.001). Conclusion. The routine use of focal ultrasound in patients with STEMI does not increase the time to revascularization and has a high degree of diagnostic accuracy.

Correlation between admission blood glucose, fibrinogen, and slow blood flow during primary PCI for acute ST segment elevation myocardial infarction

BackgroudCoronary slow flow (CSF) is a common phenomenon of coronary microcirculation dysfunction, and is closely related to elevated blood glucose and fibrinogen (FIB) levels. However, whether immediate blood glucose and FIB levels affect coronary blood flow during primary percutaneous coronary intervention (PCI) remains unclear.ObjectiveTo explore the correlation between admission blood glucose (ABG), fibrinogen (FIB) and slow blood flow during primary PCI for acute ST segment elevation myocardial infarction (STEMI).MethodsA total of 497 patients who underwent coronary angiography in the cardiology department of the 904th Hospital of the Joint Logistics Support Force from December 2018 to December 2022 due to STEMI were selected consecutively, and then were divided into two groups based on whether slow blood flow occurred during primary PCI: slow blood flow group (n = 117) and control group (n = 380). Detecting the ABG, FIB and other indicators of patients in each group, and using logistic regression analysis and receiver operating characteristic (ROC) curve to analyze independent risk factors for slow blood flow during primary PCI, and further evaluating the prognosis of patients.ResultsThe levels of ABG and FIB in patients with slow blood flow were significantly higher than those in the control group (P &amp;lt; 0.05). The results of multivariate logistic regression analysis suggested that FIB and ABG were independent risk factors for slow blood flow during primary PCI (both P &amp;lt; 0.05). ROC curve analysis showed that ABG, FIB, and their combination all had predictive value for slow blood flow during primary PCI (all P &amp;lt; 0.05), and the area under the curve (AUC) of the combined indicator was higher than that of any single indicator, with statistical significance (P &amp;lt; 0.05). KM curve analysis suggested that the prognosis of patients in slow blood flow group were poor.ConclusionBoth elevated ABG and FIB could predict slow blood flow during primary PCI, and the diagnostic value of the combined indicator was superior to that of any single indicator, which could be used for the evaluation of slow blood flow during primary PCI, so as to evaluate the prognosis of patients with STEMI.

Left Anterior Descending Nonculprit Lesions and Clinical Outcomes in PatientsWith ST-Segment Elevation Myocardial Infarction.

In the COMPLETE (Complete vs Culprit-Only Revascularization to Treat Multi-Vessel Disease After Early PCI for STEMI) trial, complete revascularization in patients with ST-segment elevation myocardial infarction (STEMI) and multivessel disease (MVD) reduced important outcomes compared with culprit-only percutaneous coronary intervention. Whether clinical outcomes in STEMI patients with MVD are influenced by the presence of a left anterior descending (LAD) nonculprit lesion (NCL) remains unknown. This study sought to compare: 1) cardiovascular outcomes among patients with an NCL in the proximal/mid-LAD to patients with an NCL in other locations; and 2) the benefit of NCL revascularization in patients with and without a proximal/mid-LAD NCL. The COMPLETE trial enrolled patients presenting with STEMI and MVD to angiography-guided complete revascularization vs a culprit lesion-only strategy. All coronary angiograms were evaluated in a central core laboratory. In this prespecified subanalysis, treatment effect according to proximal/mid-NCL location was determined for the coprimary outcomes of: 1) cardiovascular death or new myocardial infarction; and 2) cardiovascular death, new myocardial infarction, or ischemia-driven revascularization. Cox proportional hazards models were performed with an interaction term for treatment allocation and NCL location. Of the 4,041 subjects in COMPLETE, 1,666 patients had a proximal/mid-LAD NCL (41.2%). The first coprimary outcome occurred in 8.5% (2.9%/y) of patients with a proximal/mid-LAD NCL vs 9.9% (3.4%/y) in those without (adjusted HR: 0.83; 95%CI: 0.67-1.03). Complete revascularization had a similar benefit in reducing the first coprimary outcome for patients with a proximal/mid-LAD NCL (7.7% vs 9.2%; HR: 0.85; 95%CI: 0.61-1.18) and those without (8.0% vs 11.9%; HR: 0.65; 95%CI: 0.50-0.86), with no differential treatment effect (interaction P = 0.235) CONCLUSIONS: Among patients presenting with STEMI and multivessel CAD, those with a proximal/mid-LAD NCL had similar event rates to those without. The benefit of complete revascularization between the groups was similar, with no evidence of heterogeneity.

Differences in intravascular ultrasound findings in culprit lesions in infarct-related arteries between ST elevation Myocardial Infarction and non – ST elevation Myocardial Infarction

Differences in intravascular ultrasound findings in culprit lesions in infarct-related arteries between ST elevation Myocardial Infarction and non – ST elevation Myocardial Infarction

Impact of Adherence to Beta-Blockers in Patients With All-Comers ST-Segment Elevation Myocardial Infarction and According to Left Ventricular Ejection Fraction at Discharge: Results From the Real-World Registry FAST-STEMI.

Beta-blockers are a crucial part of post-myocardial infarction (MI) pharmacological therapy. Recent studies have raised questions about their efficacy in patients without reduced left ventricular ejection fraction (LVEF). This study aims to assess adherence to beta-blockers after discharge for ST-segment elevation myocardial infarction (STEMI) and the impact of adherence on outcomes based on LVEF at discharge. The retrospective registry FAST-STEMI evaluated real-world adherence to main cardiovascular drugs in patients with STEMI between 2012 and 2017 by comparing purchased tablets with expected ones at 1 year through pharmacy registries. Optimal adherence was defined as ≥80%. Primary outcomes included all-cause and cardiovascular death while secondary outcomes were MI, major/minor bleeding events, and ischemic stroke. The study included 4688 patients discharged on beta-blockers. The mean age was 64 ± 12.3 years, 76% were male, and the mean LVEF was 49.2 ± 8.8%. The mean adherence at 1 year was 87.1%. Optimal adherence was associated with lower all-cause (adjusted hazard ratio, 0.62, 95% confidence interval, 0.41-0.92, P : 0.02) and cardiovascular (adjusted hazards ratio, 0.55, 95% confidence interval, 0.26-0.98, P : 0.043) mortality. In patients with LVEF ≤40%, optimal adherence was linked to reduced all-cause and cardiovascular mortality, but this was not found in patients with either preserved or mildly reduced LVEF. Predictors of cardiovascular mortality included older age, chronic kidney disease, male gender, and atrial fibrillation. Optimal adherence to beta-blocker therapy in patients with all-comers STEMI reduced all-cause and cardiovascular mortality at 1 year; once stratified by LVEF, this effect was confirmed only in patients with reduced LVEF (<40%) at hospital discharge. Impact of adherence to beta-blockers in all-comers STEMI patients and according to LVEF at discharge: results from the real-world registry FAST-STEMI.

Thrombus aspiration in primary percutaneous coronary intervention in acute ST-elevation myocardial infarction patients with high thrombus burden: one-year outcomes in a tertiary healthcare center in Ho Chi Minh City

Abstract Background Primary percutaneous coronary intervention (PCI) can dislodge atherosclerotic debris, risking microvascular embolism. Thrombus aspiration (TA) before stenting in ST-segment elevation myocardial infarction (STEMI) patients has been linked to reduced mortality, lower recurrence of heart attacks, and improved cardiac function. However, limited research exists on the effectiveness of TA in Vietnam, underscoring the need for further studies to enhance cardiovascular care. This prospective observational study was conducted to evaluate the role of TA in STEMI patients admitted with a substantial thrombus burden at Nguyen Tri Phuong Hospital. Results Out of 92 participants, 68 underwent TA treatment. Post-treatment, the TA group exhibited better TIMI and TMP flow grades and a higher rate of ST-segment normalization, with no significant difference in major adverse cardiac events (MACEs) at 30-day and 12-month follow-ups compared to those untreated. Conclusions TA during PCI enhances ST-segment normalization and TIMI and TMP scores in STEMI patients, improving myocardial perfusion. No difference in MACE occurrence was noted between groups after 30 days and 12 months, suggesting TA’s potential benefits without increasing adverse outcomes.

Rethinking Beta-Blockers After ST-Segment Elevation Myocardial Infarction: Essential for Some, Questionable for Others.

Rethinking Beta-Blockers After ST-Segment Elevation Myocardial Infarction: Essential for Some, Questionable for Others.

Indirect Ballistic Injury Resulting in Non–ST-Segment Elevation Myocardial Infarction

Indirect Ballistic Injury Resulting in Non–ST-Segment Elevation Myocardial Infarction

Predictive Value of Tpeak-to-Tend/QT for Early Ventricular Arrhythmias and Arrhythmogenic Death in Patients with Anterior ST Elevation Myocardial Infarction

BackgroundPatients with anterior ST elevation myocardial infarction (STEMI) are vulnerable to life-threatening ventricular arrhythmia and arrhythmic death. This study aimed to investigate the predictive value of Tpeak-to-Tend (TpTe) and TpTe/QT ratio in patients with anterior STEMI on admission for the occurrence of in-hospital life-threatening ventricular arrhythmias and arrhythmic death. MethodsThis observational cross-sectional research was performed on patients with anterior STEMI who showed up within 12 hours of the beginning of symptoms and received the initial percutaneous coronary intervention (pPCI). The primary study endpoints included the assessment of sustained ventricular arrhythmias and all-cause/arrhythmic deaths throughout the hospitalization. Data collection involved clinical history, vital signs monitoring, ECG measurements, LVEF evaluation, and performance of pPCI procedures. ResultsThe studied patients had a mean age of 53 ± 11 years. Patients with arrhythmic events displayed a significant rise in QT dispersion, TpTe, TpTe/QT, and arrhythmic death rates (P < 0.05). A multivariate logistic regression examination revealed that HR (with an OR of 1.037 and a 95% CI of 1.004 to 1.071, P = 0.027), TpTe (with an OR of 1.025 and a 95% CI of 1.004 to 1.047, P = 0.022), and TpTe/QT (with an OR of 5.464 and a 95% CI of 2.027 to 14.726, P = 0.001) were found to be significant predictors of arrhythmic events or mortality. ConclusionIn patients with anterior STEMI, TpTe and TpTe/QT ratio are significant predictors of in-hospital VA and arrhythmic death. Higher TpTe and TpTe/QT values are linked to a higher risk of these occurrences.

Impact of wildfires and PM2.5 on ST-elevation acute coronary syndrome in Rosario City: a case-crossover study

ABSTRACT We conducted a modified case-crossover study to examine whether wildfires in the Paraná River Delta departments surrounding Rosario, Argentina, during 2021–2022 increased PM₂.₅ concentrations in this city and if this rise subsequently elevated the risk of ST-elevation myocardial infarction (STEMI). We first observed that daily PM₂.₅ levels in Rosario were significantly higher on wildfire days compared to non-wildfire days (34 µg/m3 vs. 25.75 µg/m3, p < 0.01). In the case-crossover analysis, we found that the odds of STEMI were significantly higher on days when PM₂.₅ concentrations exceeded 20 µg/m3 (OR 2.2 [95% CI 1.2–4.2, p = 0.02]). Additionally, the odds of STEMI increased with higher PM₂.₅ concentrations, with a significant difference when comparing the first and fourth quartiles concentration (OR 1.76 [95% CI 1.06–2.92, p = 0.03] and OR 2.02 [95% CI 1.25–3.27, p < 0.01], respectively). In conclusion, wildfires in the surrounding departments of Rosario City in the Paraná River Delta led to elevated PM₂.₅ levels, and this increase was associated with a higher risk of STEMI hospital admissions.

Changes in platelet maturity and reactivity following acute ST-segment elevation myocardial infarction

Changes in platelet maturity and reactivity following acute ST-segment elevation myocardial infarction

Global Longitudinal Strain in Patients with ST-Elevation Myocardial Infarction Post-Percutaneous Coronary Intervention using Speckle Tracking Echocardiography.

Global Longitudinal Strain in Patients with ST-Elevation Myocardial Infarction Post-Percutaneous Coronary Intervention using Speckle Tracking Echocardiography.

Soluble suppression of tumorigenicity 2 associated with microvascular obstruction in patients with ST-segment elevation myocardial infarction

BackgroundMicrovascular obstruction (MVO) develops in approximately 50% of patients with ST-segment elevation myocardial infarction (STEMI) after undergoing percutaneous coronary intervention (PCI). MVO is strongly linked to inflammation, myocardial fibrosis, and adverse clinical outcomes. Soluble suppression of tumorigenicity 2 (sST2) serves as a biomarker for inflammation and myocardial fibrosis. Yet, the correlation between sST2 and MVO in STEMI patients has not been fully elucidated. This study attempts to evaluate the association between sST2 levels and MVO in STEMI patients following pPCI.MethodsIn this retrospective study, 315 STEMI patients who underwent pPCI at the Affiliated Hospital of Xuzhou Medical University between June 2018 and August 2023 were included. Cardiac magnetic resonance imaging (CMR) was used to assess the characteristics of myocardial infarction and microvascular obstruction (MVO), while sST2 levels were measured upon admission.ResultsThe median time for completion of CMR after hospitalization was 5 (4, 6) days. Multivariate regression analysis showed that sST2 (OR 1.01, 95% CI 1.01–1.02, p < 0.001), peak high-sensitivity troponin T (OR 2.40, 95% CI 1.66–3.47, p < 0.001), peak high-C-reactive protein (OR 1.01, 95% CI 1.01–1.02, p < 0.001), left ventricular ejection fraction (OR 0.93, 95% CI 0.89– 0.98, p = 0.009) and age (OR 1.03, 95% CI 1.01– 1.05, p = 0.042)were independently associated with MVO.ConclusionsST2 is associated with MVO after pPCI in STEMI patients. Incorporating soluble ST2 (sST2) into the risk model for MVO leads to significant improvement.

Red Cell Distribution Width as a Marker of Disease Severity and In-hospital Mortality in Patients with ST-segment Elevation Myocardial Infarction

Red Cell Distribution Width as a Marker of Disease Severity and In-hospital Mortality in Patients with ST-segment Elevation Myocardial Infarction

In-Hospital Outcomes Associated With Initial Fibrinolysis Versus Primary Percutaneous Coronary Intervention Among Patients Residing in Rural Areas Presenting With ST-Segment Elevation Myocardial Infarction.

Background: Fibrinolysis is more commonly used to manage ST-segment elevation myocardial infarction (STEMI) in rural versus urban areas. However, little is known about the outcomes associated with this treatment strategy in rural individuals. We sought to compare in-hospital outcomes associated with the use of fibrinolysis versus primary percutaneous coronary intervention (PCI) among patients residing in rural areas presenting with STEMI. Methods: We identified adult patients with STEMI between 2016 and 2021 using the United States National Inpatient Sample. The cohort was restricted to individuals residing in rural areas. Patients were divided into 2 cohorts based on the receipt of initial fibrinolysis versus primary PCI. In-hospital outcomes were compared between cohorts, with in-hospital mortality serving as the primary outcome and length of stay (LOS) serving as a secondary outcome. Results: We identified 13 475 rural STEMI encounters receiving either initial fibrinolytic therapy (n = 1095) or primary PCI (n = 12 380). The average age and number of comorbidities were similar between cohorts. In-hospital mortality occurred in 5.2% of patients, and mean LOS for initial fibrinolysis and primary PCI patients was 3.73 ± 3.739 days and 3.45 ± 3.974 days, respectively. After adjusting for covariates, initial fibrinolysis was not associated with higher in-hospital mortality (odds ratio [OR] = 0.913; 95% confidence interval [CI] = 0.679-1.228). Initial fibrinolysis was associated with a small increase in LOS compared to primary PCI (Mean difference = 0.079 days; 95%CI = 0.035-0.123). Conclusions: In this analysis of approximately 13 000 STEMI encounters among rural individuals, patient characteristics between those treated with initial fibrinolysis versus primary PCI were similar. Observed outcomes were not meaningfully different between cohorts. Fibrinolytic therapy should not be an overlooked treatment strategy in rural STEMI patients facing delays in receipt of primary PCI.

Hepatic Tissue Alterations in ST-Elevation Myocardial Infarction: Determinants and Prognostic Implications.

The presence and clinical significance of hepatic tissue alterations as assessed by cardiac magnetic resonance imaging in patients with ST-segment-elevation myocardial infarction (STEMI), are unclear. This study aimed to investigate associations of hepatic T1 patterns with myocardial tissue damage and clinical outcomes in patients suffering from STEMI. We analyzed 485 patients with STEMI treated with percutaneous coronary intervention who were enrolled in the prospective magnetic resonance imaging in acute ST-elevation myocardial infarction study (MARINA STEMI). Myocardial function and left and right ventricular (RV) infarct characteristics were assessed by cardiac magnetic resonance within the first week after STEMI. Native hepatic T1 times and extracellular volume were evaluated from standard cardiac T1 maps at baseline and 4 months thereafter. Median hepatic T1 times were 559 ms (interquartile range, 514-605) at baseline and decreased to 542 ms (interquartile range, 507-577) at 4 months (P<0.001). Hepatic T1 times at baseline were independently associated with female sex (β 0.116; P=0.008), hyperlipidemia (β -0.116; P=0.008), and myocardial tissue damage (infarct size: β 0.178; P<0.001; microvascular obstruction: β 0.193; P<0.001; RV infarction: β 0.161; P<0.001). Determinants of hepatic T1 times at 4 months were female sex (β 0.123; P=0.002), multivessel disease (β 0.121; P=0.002), N-terminal pro-B-type natriuretic peptide (β 0.101; P=0.010), RV infarction (β 0.501; P<0.001), and RV end-systolic volume index (β 0.087; P=0.031). Patients without a decrease exhibited a higher frequency of major adverse cardiovascular events (13% versus 5%; P=0.003). Hepatic T1 times at baseline (hazard ratio, 1.87 [95% CI, 1.40-2.50]; P<0.001), 4 months (hazard ratio, 2.69 [95% CI, 2.15-3.36]; P<0.001), and hepatic extracellular volume at 4 months (hazard ratio, 1.59 [95% CI, 1.33-1.90]; P<0.001) were associated with major adverse cardiovascular events. After adjustment for univariable associates, only hepatic T1 times at 4 months were independently associated with adverse outcomes (hazard ratio, 2.86 [95% CI, 1.99-4.12]; P<0.001). Hepatic tissue alterations determined by T1 mapping were associated with female sex, hyperlipidemia, multivessel disease, N-terminal pro-B-type natriuretic peptide, and left and RV myocardial tissue damage. These alterations can persist into the chronic phase after STEMI and indicate a worse clinical outcome. URL: https://www.clinicaltrials.gov; Unique identifier: NCT04113356.

Inflammation-related markers in COVID-19 infection and ST-segment elevation myocardial infarction.

The aim of this study is to investigate the association between inflammation-related markers in COVID-19 infection and ST-segment elevation myocardial infarction (STEMI). We conducted an observational, single-center, retrospective study between January 2020 and November 2022. A total of 149 patients aged between 34 and 90 years, 28.2% (N.=42) female and 71.8% (N.=107) male, were included in the study. Systemic immune-inflammation index (SII), systemic inflammation-response indexes (SIRI), platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) were calculated for each patient. The patients were divided into two groups based on their presence or absence of a confirmed SARS-CoV-2 infection. During the in-hospital follow-up, mortality occurred in 12% (N.=20) of patients. Among the COVID-19 (+) and STEMI group, the mortality rate was 24.3% (N.=10), while it was 5.6% (N.=6) in the COVID-19 (-) and STEMI group (P=0.001). In multivariate logistic regression analysis, SII ([HR] = 7.198 [1.423-36.411], P=0.017) and PLR ([HR] = 5.762 [1.783-18.619], P=0.003) remained significant risk factor for mortality. The SII, SIRI, NLR, and PLR are relatively new, simple, and effective inflammation-related markers that determine mortality risk in STEMI patients.