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North American COVID-19 ST-Segment-Elevation Myocardial Infarction (NACMI) registry: Rationale, design, and implications.

Identifieur interne : 000252 ( Main/Corpus ); précédent : 000251; suivant : 000253

North American COVID-19 ST-Segment-Elevation Myocardial Infarction (NACMI) registry: Rationale, design, and implications.

Auteurs : Payam Dehghani ; Laura J. Davidson ; Cindy L. Grines ; Keshav Nayak ; Jacqueline Saw ; Prashant Kaul ; Akshay Bagai ; Ross Garberich ; Christian Schmidt ; Hung Q. Ly ; Jay Giri ; Perwaiz Meraj ; Binita Shah ; Santiago Garcia ; Scott Sharkey ; David A. Wood ; Frederick G. Welt ; Ehtisham Mahmud ; Timothy D. Henry

Source :

RBID : pubmed:32425198

Abstract

The novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), that causes coronavirus disease 2019 (COVID-19), has resulted in a global pandemic. Patients with cardiovascular risk factors or established cardiovascular disease are more likely to experience severe or critical COVID-19 illness and myocardial injury is a key extra-pulmonary manifestation. These patients frequently present with ST-elevation on an electrocardiogram (ECG) due to multiple etiologies including obstructive, non-obstructive, and/or angiographically normal coronary arteries. The incidence of ST-elevation myocardial infarction (STEMI) mimics in COVID-19-positive hospitalized patients, and the association with morbidity and mortality is unknown. Understanding the natural history and appropriate management of COVID-19 patients presenting with ST elevation is essential to inform patient management decisions and protect healthcare workers. METHODS: The Society for Cardiovascular Angiography and Interventions (SCAI) and The Canadian Association of Interventional Cardiology (CAIC) in conjunction with the American College of Cardiology Interventional Council have collaborated to create a multi-center observational registry, NACMI. This registry will enroll confirmed COVID-19 patients and persons under investigation (PUI) with new ST-segment elevation or new onset left bundle branch block (LBBB) on the ECG with clinical suspicion of myocardial ischemia. We will compare demographics, clinical findings, outcomes and management of these patients with a historical control group of over 15,000 consecutive STEMI activation patients from the Midwest STEMI Consortium using propensity matching. The primary clinical outcome will be in- hospital major adverse cardiovascular events (MACE) defined as composite of all-cause mortality, stroke, recurrent MI, and repeat unplanned revascularization in COVID-19 confirmed or PUI. Secondary outcomes will include the following: reporting of etiologies of ST Elevation; cardiovascular mortality due to myocardial infarction, cardiac arrest and /or shock; individual components of the primary outcome; composite primary outcome at 1 year; as well as ECG and angiographic characteristics. CONCLUSION: The multicenter NACMI registry will collect data regarding ST elevation on ECG in COVID-19 patients to determine the etiology and associated clinical outcomes. The collaboration and speed with which this registry has been created, refined, and promoted serves as a template for future research endeavors.

DOI: 10.1016/j.ahj.2020.05.006
PubMed: 32425198
PubMed Central: PMC7229476

Links to Exploration step

pubmed:32425198

Le document en format XML

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<name sortKey="Bagai, Akshay" sort="Bagai, Akshay" uniqKey="Bagai A" first="Akshay" last="Bagai">Akshay Bagai</name>
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<name sortKey="Schmidt, Christian" sort="Schmidt, Christian" uniqKey="Schmidt C" first="Christian" last="Schmidt">Christian Schmidt</name>
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<name sortKey="Ly, Hung Q" sort="Ly, Hung Q" uniqKey="Ly H" first="Hung Q" last="Ly">Hung Q. Ly</name>
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<name sortKey="Giri, Jay" sort="Giri, Jay" uniqKey="Giri J" first="Jay" last="Giri">Jay Giri</name>
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<nlm:affiliation>Cardiovascular Medicine Division, University of Pennsylvania, Philadelphia, PA.</nlm:affiliation>
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<name sortKey="Shah, Binita" sort="Shah, Binita" uniqKey="Shah B" first="Binita" last="Shah">Binita Shah</name>
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<nlm:affiliation>Department of Medicine (Cardiology), VA New York Harbor Healthcare System and New York University School of Medicine, New York, NY.</nlm:affiliation>
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<name sortKey="Garcia, Santiago" sort="Garcia, Santiago" uniqKey="Garcia S" first="Santiago" last="Garcia">Santiago Garcia</name>
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<nlm:affiliation>Society for Cardiovascular Angiography and Interventions, Washington, DC; Minneapolis Heart Institute, Minneapolis, MN.</nlm:affiliation>
</affiliation>
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<name sortKey="Sharkey, Scott" sort="Sharkey, Scott" uniqKey="Sharkey S" first="Scott" last="Sharkey">Scott Sharkey</name>
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<nlm:affiliation>Minneapolis Heart Institute, Minneapolis, MN.</nlm:affiliation>
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<name sortKey="Wood, David A" sort="Wood, David A" uniqKey="Wood D" first="David A" last="Wood">David A. Wood</name>
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<nlm:affiliation>Canadian Association of Interventional Cardiology, Ottawa, Ontario, Canada; Centre for Cardiovascular Innovation, UBC Division of Cardiology, St Paul's and Vancouver General Hospital, Vancouver, Canada.</nlm:affiliation>
</affiliation>
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<name sortKey="Welt, Frederick G" sort="Welt, Frederick G" uniqKey="Welt F" first="Frederick G" last="Welt">Frederick G. Welt</name>
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<nlm:affiliation>American College of Cardiology Interventional Cardiology Section Leadership Council, Washington, DC; Society for Cardiovascular Angiography and Interventions, Washington, DC; Cardiovascular Division, University of Utah Health, Salt Lake City, UT.</nlm:affiliation>
</affiliation>
</author>
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<name sortKey="Mahmud, Ehtisham" sort="Mahmud, Ehtisham" uniqKey="Mahmud E" first="Ehtisham" last="Mahmud">Ehtisham Mahmud</name>
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<nlm:affiliation>Society for Cardiovascular Angiography and Interventions, Washington, DC; University of California, San Diego, Sulpizio Cardiovascular Center, La Jolla, CA.</nlm:affiliation>
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<name sortKey="Henry, Timothy D" sort="Henry, Timothy D" uniqKey="Henry T" first="Timothy D" last="Henry">Timothy D. Henry</name>
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<nlm:affiliation>American College of Cardiology Interventional Cardiology Section Leadership Council, Washington, DC; Society for Cardiovascular Angiography and Interventions, Washington, DC; The Carl and Edyth Lindner Center for Research and Education, The Christ Hospital, Cincinnati, OH. Electronic address: Tim.henry@thechristhospital.com.</nlm:affiliation>
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<div type="abstract" xml:lang="en">The novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), that causes coronavirus disease 2019 (COVID-19), has resulted in a global pandemic. Patients with cardiovascular risk factors or established cardiovascular disease are more likely to experience severe or critical COVID-19 illness and myocardial injury is a key extra-pulmonary manifestation. These patients frequently present with ST-elevation on an electrocardiogram (ECG) due to multiple etiologies including obstructive, non-obstructive, and/or angiographically normal coronary arteries. The incidence of ST-elevation myocardial infarction (STEMI) mimics in COVID-19-positive hospitalized patients, and the association with morbidity and mortality is unknown. Understanding the natural history and appropriate management of COVID-19 patients presenting with ST elevation is essential to inform patient management decisions and protect healthcare workers. METHODS: The Society for Cardiovascular Angiography and Interventions (SCAI) and The Canadian Association of Interventional Cardiology (CAIC) in conjunction with the American College of Cardiology Interventional Council have collaborated to create a multi-center observational registry, NACMI. This registry will enroll confirmed COVID-19 patients and persons under investigation (PUI) with new ST-segment elevation or new onset left bundle branch block (LBBB) on the ECG with clinical suspicion of myocardial ischemia. We will compare demographics, clinical findings, outcomes and management of these patients with a historical control group of over 15,000 consecutive STEMI activation patients from the Midwest STEMI Consortium using propensity matching. The primary clinical outcome will be in- hospital major adverse cardiovascular events (MACE) defined as composite of all-cause mortality, stroke, recurrent MI, and repeat unplanned revascularization in COVID-19 confirmed or PUI. Secondary outcomes will include the following: reporting of etiologies of ST Elevation; cardiovascular mortality due to myocardial infarction, cardiac arrest and /or shock; individual components of the primary outcome; composite primary outcome at 1 year; as well as ECG and angiographic characteristics. CONCLUSION: The multicenter NACMI registry will collect data regarding ST elevation on ECG in COVID-19 patients to determine the etiology and associated clinical outcomes. The collaboration and speed with which this registry has been created, refined, and promoted serves as a template for future research endeavors.</div>
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<AbstractText>The novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), that causes coronavirus disease 2019 (COVID-19), has resulted in a global pandemic. Patients with cardiovascular risk factors or established cardiovascular disease are more likely to experience severe or critical COVID-19 illness and myocardial injury is a key extra-pulmonary manifestation. These patients frequently present with ST-elevation on an electrocardiogram (ECG) due to multiple etiologies including obstructive, non-obstructive, and/or angiographically normal coronary arteries. The incidence of ST-elevation myocardial infarction (STEMI) mimics in COVID-19-positive hospitalized patients, and the association with morbidity and mortality is unknown. Understanding the natural history and appropriate management of COVID-19 patients presenting with ST elevation is essential to inform patient management decisions and protect healthcare workers. METHODS: The Society for Cardiovascular Angiography and Interventions (SCAI) and The Canadian Association of Interventional Cardiology (CAIC) in conjunction with the American College of Cardiology Interventional Council have collaborated to create a multi-center observational registry, NACMI. This registry will enroll confirmed COVID-19 patients and persons under investigation (PUI) with new ST-segment elevation or new onset left bundle branch block (LBBB) on the ECG with clinical suspicion of myocardial ischemia. We will compare demographics, clinical findings, outcomes and management of these patients with a historical control group of over 15,000 consecutive STEMI activation patients from the Midwest STEMI Consortium using propensity matching. The primary clinical outcome will be in- hospital major adverse cardiovascular events (MACE) defined as composite of all-cause mortality, stroke, recurrent MI, and repeat unplanned revascularization in COVID-19 confirmed or PUI. Secondary outcomes will include the following: reporting of etiologies of ST Elevation; cardiovascular mortality due to myocardial infarction, cardiac arrest and /or shock; individual components of the primary outcome; composite primary outcome at 1 year; as well as ECG and angiographic characteristics. CONCLUSION: The multicenter NACMI registry will collect data regarding ST elevation on ECG in COVID-19 patients to determine the etiology and associated clinical outcomes. The collaboration and speed with which this registry has been created, refined, and promoted serves as a template for future research endeavors.</AbstractText>
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