Comparative Analysis of Patients With STEMI and COVID-19 Between Canada and the United States

作者：Jay Shavadia, Larissa Stanberry, Jyotpal Singh, Kiahltone R. Thao, Nima Ghasemzadeh, Nestor Mercado, Keshav R. Nayak, M. Chadi Alraies, Rodrigo Bagur, Jacqueline Saw, Akshay Bagai, Kevin R. Bainey, Mina Madan, Shy Amlani, Ross Garberich, Cindy L. Grines, Santiago García, Timothy D. Henry, Payam Dehghani · 发表于：Journal of the Society for Cardiovascular Angiography & Interventions · 年份：2023 · DOI：10.1016/j.jscai.2023.100970 · 被引用次数：3 · 研究领域：SARS-CoV-2 and COVID-19 Research、COVID-19 and healthcare impacts、Acute Myocardial Infarction Research

Background Important health care differences exist between the United States (US) and Canada, which may have been exacerbated during the pandemic. We compared clinical characteristics, treatment strategies, and clinical outcomes of patients with ST-segment elevation myocardial infarction (STEMI) and COVID-19 (STEMI-COVID) treated in the US and Canada. Methods The North American COVID-19 Myocardial Infarction registry is a prospective, investigator-initiated study enrolling patients with STEMI with confirmed or suspected COVID-19 in the US and Canada. The primary end point was in-hospital mortality. Additionally, we explored associations between vaccination and clinical outcomes. Results Of 853 patients with STEMI-COVID, 112 (13%) were enrolled in Canada, and compared with the US, patients in Canada were more likely to present with chest pain and less likely to have a history of heart failure, stroke/transient ischemic attack, pulmonary infiltrates or renal failure. In both countries, the primary percutaneous coronary intervention was the dominant reperfusion strategy, with no difference in door-to-balloon times; fibrinolysis was used less frequently in the US than in Canada. The adjusted in-hospital mortality was not different between the 2 countries (relative risk [RR], 1.0; 95% CI, 0.46-2.72; P = 1.0). However, the risk of in-hospital mortality was significantly higher in unvaccinated compared with vaccinated patients with STEMI-COVID (RR, 4.7; 95% CI, 1.7-11.53; P = .015)....