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

  1. Iana Simova
  2. Denis Nikolov
  3. Nikolay Dimitrov
  4. Vladimir Kornovski
  5. Vesela Tomova
  6. Toni Vekov
  7. Yordan Krasnaliev

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Abstract

INTRODUCTION

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.

AIMS

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%

CONCLUSION

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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    SciScore for 10.1101/2021.02.07.21251081: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementConsent: Ethics: All patients signed an informed consent for coronary angiography and PCI, and for personal data analysis.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Statistical analyses: Statistical analyses were performed using SPSS statistical software for Windows version 19.0.
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2021.02.07.21251081v1 on medRxiv