Previously submitted to: Interactive Journal of Medical Research (no longer under consideration since Jan 04, 2022)
Date Submitted: Mar 1, 2021
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
How to decide which COVID-19 patient with myocardial infarction to send to the Cath Lab? - A case series of COVID-19 patients with myocardial infarction
ABSTRACT
Background:
The Coronavirus pandemic has hit the world with its vast contagiousness, high morbidity, and mortality. Apart from the direct damage to the lung tissue, the corona virus infection is able to predispose patients to thrombotic disease, thus causing cerebral or coronary incidents.
Objective:
The aim of this study was to find a clinical or laboratory parameter, that would help in distinguishing between COVID-19 patients with myocardial infarction (MI), who have an infarct-related artery (IRA) and therefore, require immediate revascularization, and those, who have no IRA.
Methods:
This was a single-center, observational study of 10 consecutive patients with COVID-19, who were admitted with confirmed MI.
Results:
In our study group the mean age was 67.5 ± 8.3 years, half of the patients were female; all of them had arterial hypertension; 8 patients (80%) had dyslipidemy; 4 (40%) had diabetes. 30% of the patients with MI did not have an IRA, and did not require pPCI. Patients with MI and IRA had significantly higher hsTrI values (48.9 ± 43.2 vs 0.6 ± 0.7, p=0.007) and exclusively typical chest pain 100% vs 0%, p=0.007), compared to patients with MI without an IRA. The ECG changes had only marginal statistical significance. Our results suggest that using a higher cut-off value for hsTrI (>7.5 times upper reference range) increases the specificity and positive predictive value for diagnosing a MI with the presence of IRA and need for pPCI, to 100%
Conclusions:
In our analysis we confirm that a higher cut-off value for hsTrI helps distinguish between COVID patients with MI, who have IRA and therefore, require immediate revascularization, compared to those, who have no IRA.
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