<\/b><\/p>\n
<\/b><\/p>\n
WEDNESDAY, April 22, 2020 (HealthDay News) — For patients with COVID-19 who have ST-segment elevation, indicating potential acute myocardial infarction, there is considerable variability in presentation, and prognosis is poor, according to a letter to the editor published online April 17 in the New England Journal of Medicine<\/i>.<\/p>\n
Sripal Bangalore, M.D., from New York University Grossman School of Medicine in New York City, and colleagues describe their experience involving patients with confirmed COVID-19 who had ST-segment elevation on electrocardiography from six New York hospitals.<\/p>\n
The researchers identified 18 patients with ST-segment elevation indicating potential acute myocardial infarction (median age, 63 years; 83 percent male), of whom 33 percent had chest pain around the time of ST-segment elevation. Ten patients had ST-segment elevation at the time of presentation and eight developed ST-segment elevation during hospitalization. Five of 14 patients with focal ST-segment elevation had a normal left ventricular ejection fraction, one of whom had a regional wall-motion abnormality. Eight patients had a reduced left ventricular ejection fraction. Nine patients underwent coronary angiography and six of these had obstructive disease; five patients underwent percutaneous coronary intervention. Higher median peak troponin and D-dimer levels were seen among the eight patients who received a clinical diagnosis of myocardial infarction versus the 10 with noncoronary myocardial injury. Thirteen patients died in the hospital, including four and nine with myocardial infarction and noncoronary myocardial injury, respectively.<\/p>\n
“In this series of patients with COVID-19 who had ST-segment elevation, there was variability in presentation, a high prevalence of nonobstructive disease, and a poor prognosis,” the authors write.<\/p>\n