Should a recent SARS-CoV-2 infection be considered a risk or prognostic factor for ST-segment elevation myocardial infarction?

Kietseé A. Díaz-Domínguez, Department of Immunology, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, Mexico
Andrés Cruz-Melendez, Core Lab, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México
Luis M. Amezcua-Castillo, Coronary Care Unit, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México
Jazmin A. Guerra-López, Department of Immunology, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México
Claudia Tavera-Alonso, Core Lab, Instituto Nacional de Cardiología Ignacio Chávez, Ciudad de México, México
Hector González-Pacheco, Unidad Coronaria, Instituto Nacional de Cardiología Ignacio Chávez. Ciudad de México, México
Luis M. Amezcua-Guerra, Department of Immunology, Instituto Nacional de Cardiología Ignacio Chávez; Department of Health Care, Universidad Autónoma Metropolitana-Xochimilco; Ciudad de México, México

Objective: The aim of the study was to assess whether a recent SARS-CoV-2 infection could by itself be a risk or prognostic factor for ST-segment elevation myocardial infarction (STEMI). Method: An observational study in unvaccinated patients with STEMI confirmed by cardiac catheterization was conducted. A recent or concurrent SARS-CoV-2 infection was identified by the presence of serum IgG against the nucleocapsid protein, or a positive polymerase chain reaction test on nasopharyngeal swabs. Baseline cardiovascular risk factors, clinical STEMI severity, main catheterization findings, and occurrence of major adverse cardiovascular events (MACE) during hospitalization were compared between study subgroups. Results: Of a total of 89 patients recruited, 14 (16%) had a recent SARS-CoV-2 infection. Patients with STEMI and recent SARS-CoV-2 infection had a markedly lower frequency of high blood pressure (20% versus 55%; P = 0.03) as well as a tendency to have fewer comorbidities. Regarding the clinical presentation, there were no differences in the severity of the STEMI. Furthermore, the main findings during cardiac catheterization including the atherosclerotic burden and the number of vessels affected, as well as the occurrence of MACE during follow-up, were not significantly different between the groups. Conclusions: A recent SARS-CoV-2 infection appears to facilitate the triggering of STEMI, as these patients have fewer traditional cardiovascular risk factors than their uninfected counterparts. However, this does not seem to affect the clinical presentation or the in-hospital course of STEMI patients.

Palabras clave: Coronavirus disease 2019. SARS-CoV-2. ST-segment elevation myocardial infarction. Acute coronary syndrome.