eISSN: 1897-4295
ISSN: 1734-9338
Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
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vol. 19
Original paper

COVID-19 as an independent predictor of aspiration thrombectomy in STEMI. National data from the ORPKI register in the years 2020–2022

Patrycja Zając
Karol Kaziród-Wolski
Janusz Sielski
Magdalena Wolska
Krzysztof Piotr Malinowski
Zbigniew Siudak

Rheumatology Department of the Province Hospital, Końskie, Poland
Collegium Medicum, Jan Kochanowski University, Kielce, Poland
Outpatient Treatment Facility “CenterMed”, Kielce, Poland
Department of Bioinformatics and Telemedicine, Jagiellonian University Medical College, Krakow, Poland
Adv Interv Cardiol 2023; 19, 2 (72): 119–126
Online publish date: 2023/06/05
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Coronavirus disease 2019 (COVID-19) exacerbates intravascular thrombosis that occurs in the coronary artery in ST-elevation myocardial infarction (STEMI).

To analyze the impact of COVID-19 on the application and effect of thrombectomy in STEMI patients.

Material and methods:
29915 STEMI patients were analyzed, of whom 3139 (10.5%) underwent thrombectomy. COVID-19 (+) was reported in 311 (10.8%). The clinical characteristics and management of STEMI in COVID-19 (+) and COVID-19 (–) patients were compared. A multivariable logistic regression analysis was performed in search of factors influencing thrombectomy.

COVID-19 (+) patients had higher Killip class (IV class; n = 33 (12.31%) vs. n = 138 (5.84%); p < 0.0001) and cardiac arrest at baseline was more frequent in this group (n = 25 (8.04%) vs. n = 137 (4.84%); p = 0.016). Thrombolysis in myocardial infarction (TIMI) 3 after percutaneous coronary intervention was less frequent (n = 248 (80.52%) vs. n = 2388 (87.19%); p = 0.001) in the COVID-19 (–) group. Periprocedural mortality was similar in both groups (n = 28 (0.99%) vs. n = 4 (1.29%); p = 0.622). In multivariable regression analysis COVID-19 increased the risk of thrombectomy (OR = 1.23; 97.5% CI: 1.05–1.43; p = 0.001).

STEMI patients undergoing aspiration thrombectomy who were COVID-19 (+) were more likely to be in a severe clinical condition (higher Killip class, more frequent cardiac arrest before the procedure) than COVID-19 (–) patients. Despite more intensive antiplatelet and anticoagulant treatment, PCI procedures were less likely to result in an optimal TIMI 3 effect. COVID-19 is an independent strong predictor of patient qualification for aspiration thrombectomy in STEMI.


thrombectomy, percutaneous coronary intervention, acute coronary syndrome, COVID-19, myocardial infarction, coronary thrombosis

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