SARS-CoV-2 Positivity, Stent Thrombosis, and 30-day Mortality in STEMI Patients Undergoing Mechanical Reperfusion

G. De Luca*, M. Algowhary, B. Uguz, D.C. Oliveira, V. Ganyukov, Z. Zimbakov, M. Cercek, L.O. Jensen, P.H. Loh, L. Calmac, G.R.I. Ferrer, A. Quadros, M. Milewski, F.S. Di Uccio, C. von Birgelen, F. Versaci, J. Ten Berg, G. Casella, A.W.S. Lung, P. KalaJ.L.D. Gil, X. Carrillo, M. Dirksen, V.M. Becerra-Munoz, M.K.Y. Lee, D.A. Juzar, R.D. Joaquim, C. De Simone, D. Milicic, P. Davlouros, N. Bakraceski, F. Zilio, L. Donazzan, A. Kraaijeveld, G. Galasso, L. Arpad, L. Marinucci, V. Guiducci, M. Menichelli, A. Scoccia, A.H. Yamac, K.U. Mert, X.F. Rios, T. Kovarnik, M. Kidawa, J. Moreu, V. Flavien, E. Fabris, I.L. Martinez-Luengas, M. Boccalatte

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


SARS-Cov-2 has been suggested to promote thrombotic complications and higher mortality. The aim of the present study was to evaluate the impact of SARS-CoV-2 positivity on in-hospital outcome and 30-day mortality in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI) enrolled in the International Survey on Acute Coronary Syndromes ST-segment elevation Myocardial Infarction (ISACS-STEMI COVID-19 registry. The 109 SARS-CoV-2 positive patients were compared with 2005 SARS-CoV-2 negative patients. Positive patients were older (P = .002), less often active smokers (P = .002), and hypercholesterolemic (P = .006), they presented more often later than 12 h (P = .037), more often to the hub and were more often in cardiogenic shock (P = .02), or requiring rescue percutaneous coronary intervention after failed thrombolysis (P < .0001). Lower postprocedural Thrombolysis in Myocardial Infarction 3 flow (P = .029) and more thrombectomy (P = .046) were observed. SARS-CoV-2 was associated with a significantly higher in-hospital mortality (25.7 vs 7%, adjusted Odds Ratio (OR) [95% Confidence Interval] = 3.2 [1.71-5.99], P < .001) in-hospital definite in-stent thrombosis (6.4 vs 1.1%, adjusted Odds Ratio [95% CI] = 6.26 [2.41-16.25], P < .001) and 30-day mortality (34.4 vs 8.5%, adjusted Hazard Ratio [95% CI] = 2.16 [1.45-3.23], P < .001), confirming that SARS-CoV-2 positivity is associated with impaired reperfusion, with negative prognostic consequences.
Original languageEnglish
Number of pages10
Publication statusE-pub ahead of print - 1 Oct 2022


  • thrombosis
  • outcome
  • COVID-19

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