Acute coronary syndrome in COVID-19 patients. Clinical features, severity and outcomes. Results from Spanish multicenter registry Car-COVID19

Abstract

Abstract Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): Fundación del Corazón Introduction COVID19 has spread uncontrollably all over the world through this 2020 year. As a new entity, we did not know the potential cardiovascular manifestations of this infectious disease. This national registry was created to describe the cardiac affection and its severity. Methods and results A multicenter registry was conducted, including 28 centers in Spain. Patients with COVID19 diagnosis presenting an acute cardiovascular event between March 1st and May 30th were included. Eighty-two patients were included. Of them, 49 (76,6%) presented with acute coronary syndrome; the rest were diagnosed of acute myocarditis or stress cardiomyopathy. The majority of cases were STEMI (n\u2009=\u200931), while the remaining 35,4% presented as NSTEMI. 29 patients (61,7%) underwent emergent percutaneous coronary intervention (PCI) (Figure 1). Anterior (n\u2009=\u200918) and inferior (n\u2009=\u200916) were the most frequent locations. Coronary angiogram showed total occlusion in 20 patients (55,6%); while 7 patients presented with non-obstructive coronary arteries. PCI was done in 31 patients. Eight patients (17,8%) developed Killip III-IV myocardial infarction. A total of 10 patients required endotracheal intubation and vasoactive agent were needed in 11 patients; none required IABP or ECMO. In-hospital mortality rate was 26,2%. Conclusions Patients with COVID19 may present with acute coronary syndromes. This entity has a poor prognosis, with noteworthy mortality. Table 1. Baseline characteristics. n (%) Age 69,0[63,0-76,5] Sex (female) 9 (19,1%) Hypertension 28 (57,1%) Dyslipidemia 25 (51,0%) Diabetes mellitus 11 (22,4%) Chronic coronary disease 10 (20,4%) Previous PCI 10 (20,4%) Previous CABG 0 Previous AAS 15 (30,6%) Smoking 10 (20,4%) PCI percutaneous coronary intervention; CABG: coronary artery bypass graft; AAS: aspirin. Abstract Figure 1.