Key result
Primary PCI failed to restore coronary blood flow due to massive thrombotic burden in a 58-year-old female with COVID-19 and STEMI, leading to hemodynamic deterioration and death.
Why the study?
Due to its rapid worldwide spread, COVID-19 may influence the prognosis of other medical conditions, such as STEMI.
Case Report (n=1)
COVID-19 may induce massive coronary thrombosis in STEMI patients, leading to primary PCI failure and suggesting a potential need for potent P2Y12 and GPIIb/IIIa inhibitors.
May indicate refractory thrombosis limiting primary PCI success in COVID-19 STEMI; hypothesis-generating for adjunctive antithrombotics.
COVID-19 is a new viral infection that has a significant impact on global health and economy. Because of its rapid spread worldwide, it may influence the prognosis of other medical conditions, such as ST-segment elevation myocardial infarction (STEMI). We report a case of a 58-year female patient admitted with an infero-posterior STEMI on the background of recently positive COVID-19 swab. Reperfusion was attempted through primary PCI but unfortunately failed to restore coronary blood flow due to massive thrombotic burden despite several attempts of balloon dilatation and aspiration thrombectomy. She sadly died later on because of hemodynamic deterioration. This scenario raises concerns about Neutrophil Extracellular Traps (NETS) which might potentially have propagated inflammation and thrombosis via platelets' aggregation leading to enhanced coagulopathy and massive coronary thrombosis. Therefore, we suggest primary PCI as the first-choice of revascularization in patients with combined COVID-19 and STEMI. Additionally, we emphasize on the importance of using the potent new generation P2Y12 inhibitors along with GPIIb/IIIa inhibitors in every STEMI patient with COVID-19 to achieve favorable conditions for primary PCI as well as favorable outcomes after stent implantation.
No takes yet. Share an insight, caveat, or question.
Seif et al. (2020) conducted a case report in COVID-19 and ST-elevation myocardial infarction (STEMI) (n=1). Primary percutaneous coronary intervention (PCI) was evaluated on Restoration of coronary blood flow and survival. Primary PCI failed to restore coronary blood flow due to massive thrombotic burden in a 58-year-old female with COVID-19 and STEMI, leading to hemodynamic deterioration and death.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: