What is the clinical evidence from this study?

Study design: Cohort. Population: Acute coronary syndrome (n=279662). Intervention: COVID-19 positivity vs. Patients without COVID-19. Primary outcome: In-hospital all-cause mortality (aOR 1.46, 95% CI 1.21–1.77, p=<0.001).

What question did this study set out to answer?

This study aims to determine the prognostic implications of concurrent COVID-19 in patients with acute coronary syndrome who undergo percutaneous coronary intervention.

March 15, 2026Circulation Journal0 citationsOpen Access

Prognostic Impact of COVID-19 on Patients With Acute Coronary Syndrome Undergoing Emergent Percutaneous Coronary Intervention　― Insights From the J-PCI Nationwide Registry ―

Q: What are the key findings of this study?

COVID-19 positivity increased in-hospital all-cause mortality by 7.23% compared to 4.30% in non-COVID-19 patients, with an aOR of 1.46 (95% CI 1.21–1.77).

Q: What question did this study set out to answer?

This study aims to determine the prognostic implications of concurrent COVID-19 in patients with acute coronary syndrome who undergo percutaneous coronary intervention.

YKYoshihisa Kanaji KYKyohei Yamaji AKAyako Kunimura

Key Result

COVID-19 positivity increased in-hospital all-cause mortality by 7.23% compared to 4.30% in non-COVID-19 patients, with an aOR of 1.46 (95% CI 1.21–1.77).

Key Points

This study aims to determine the prognostic implications of concurrent COVID-19 in patients with acute coronary syndrome who undergo percutaneous coronary intervention.
Analyzed data from the J-PCI nationwide registry
Examined patients with acute coronary syndrome undergoing emergent PCI
Assessed clinical outcomes associated with concurrent COVID-19
Findings indicate that concurrent COVID-19 worsens clinical outcomes in ACS patients undergoing PCI
Increased mortality risk was observed in patients with both ACS and COVID-19
Significant implications for patient management strategies were identified.

Study Design

Type

Cohort (n=279,662)

Multicenter

Yes

Structured PICO

Does concomitant COVID-19 infection increase in-hospital mortality in patients with acute coronary syndrome undergoing emergent percutaneous coronary intervention?

Population

279,662 patients diagnosed with acute coronary syndrome (STEMI, NSTEMI, and unstable angina pectoris) undergoing primary or emergent percutaneous coronary intervention (PCI) in Japan between January 2021 and December 2023. Mean age 71, 75.8% male.

Intervention

Concomitant COVID-19 infection at the time of hospitalization (n=1,812)

Comparator

COVID-19 negative status at the time of hospitalization (n=277,850)

Outcome

All-cause in-hospital mortalityhard clinical

Concomitant COVID-19 infection in patients undergoing emergent PCI for ACS is independently associated with a 46% increased risk of in-hospital all-cause mortality.

Main Result

Effect estimate: aOR 1.46 (95% CI 1.21–1.77)

Absolute Event Rate: 7.23% vs 4.3%

p-value: p=<0.001

Limitations

Retrospective design limits causal inference
Included only patients undergoing PCI, excluding those managed without it
Did not account for regional variations in COVID-19 incidence
Data on COVID-19 severity was not systematically captured
Limited to in-hospital outcomes; long-term effects unknown
Low number of stent thrombosis events limits conclusions on that outcome
Attribution of cause of death in complex cases is challenging

Abstract

Background: Although the COVID-19 pandemic has impacted the management of acute coronary syndrome (ACS), the prognostic implications for ACS patients with concurrent COVID-19 undergoing percutaneous coronary intervention (PCI) remain to be determined, particularly in large nationwide cohorts. This study investigated the association between concomitant COVID-19 and clinical outcomes in patients undergoing emergent PCI for ACS.

اسأل الذكاء الاصطناعي

Bookmark

View Full Paper

Cite This Study

Kanaji et al. (Thu,) conducted a cohort in Acute coronary syndrome (n=279,662). COVID-19 positivity vs. Patients without COVID-19 was evaluated on In-hospital all-cause mortality (aOR 1.46, 95% CI 1.21–1.77, p=<0.001). COVID-19 positivity increased in-hospital all-cause mortality by 7.23% compared to 4.30% in non-COVID-19 patients, with an aOR of 1.46 (95% CI 1.21–1.77).

synapsesocial.com/papers/69b64ccdb42794e3e660df11 https://doi.org/https://doi.org/10.1253/circj.cj-25-0705