This was a registry-based retrospective analysis of patients admitted with positive COVID-19 tests who developed acute myocardial infarction either before or during hospitalization. This study was conducted from March to April 2020 at Tehran Heart Center. We performed an exploratory analysis to compare the clinical characteristics of patients who died during hospitalization or were discharged alive.
Fifty-seven patients who had an acute myocardial infarction and a confirmed diagnosis of COVID-19 were included in the study. During hospitalization, 13 patients (22.8%) died after a mean hospital stay of 8.4 days.
The deceased patients were older than the survivors. No significant association between mortality and sex or length of hospital stay was observed. Individuals with hypertension were more likely to have a fatal outcome. Previously receiving angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers did not show any association with mortality. Regarding the laboratory data during hospitalization, higher cardiac troponin T, neutrophil count, C-reactive protein, urea, and blood urea nitrogen/creatinine ratio were observed in the mortality group. The deceased had a lower lymphocyte count than the survivors.
We concluded that renal dysfunction and immune system disturbance were associated with mortality in concurrent acute myocardial infarction and COVID-19. Optimizing the management of acute coronary syndrome complicating COVID-19 requires addressing such potential contributors to mortality.
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