Updates on the Management of STEMI in 2021: Beyond COVID-19

This particular analysis represents an update of the previously published larger NACMI (North American COVID-19 STEMI) registry,2 which was established at the very beginning of the pandemic and analyzed the prognostic impact of SARS-CoV-2 infection in 64 centers in the United States and Canada. The first data in 2020 demonstrated that COVID-19???positive patients were less likely to receive coronary angiography and primary percutaneous coronary intervention (PCI), with negative prognostic consequences: in fact, the primary outcome of major adverse cardiovascular events occurred in 36% of the patients with COVID-19, 13% of patients suspected to have COVID-19, and 8% of control patients (P < 0.01). However, mortality was halved among the patients undergoing primary PCI, even despite COVID-19 infection (28% vs 48% in patients medically managed). In addition, minority populations and patients with diabetes mellitus were more common in COVID cases, as well as high-risk features such as dyspnea, pulmonary infiltrates, and shock, preventing invasive management and worsening the outcomes. Superscript/Subscript Available更多