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2020 ; 227
(ä): 11-18
Nephropedia Template TP
gab.com Text
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English Wikipedia
North American COVID-19 ST-Segment-Elevation Myocardial Infarction (NACMI)
registry: Rationale, design, and implications
#MMPMID32425198
Dehghani P
; Davidson LJ
; Grines CL
; Nayak K
; Saw J
; Kaul P
; Bagai A
; Garberich R
; Schmidt C
; Ly HQ
; Giri J
; Meraj P
; Shah B
; Garcia S
; Sharkey S
; Wood DA
; Welt FG
; Mahmud E
; Henry TD
Am Heart J
2020[Sep]; 227
(ä): 11-18
PMID32425198
show ga
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.