Assessing the Impact of COVID-19 on Angiographic Characteristics in Patients with ST- Elevation Myocardial Infarction: A Matched Cohort Analysis

Assessing the Impact of COVID-19 on Angiographic Characteristics in Patients with ST- Elevation Myocardial Infarction: A Matched Cohort Analysis | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Assessing the Impact of COVID-19 on Angiographic Characteristics in Patients with ST- Elevation Myocardial Infarction: A Matched Cohort Analysis Ghorbani Mina, Jafaripour Iraj, Ziaie Naghmeh, Saravi Mehrdad This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6339446/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background The COVID-19 pandemic has significantly influenced the presentation and management of cardiovascular disease, raising concerns regarding increased thrombotic events and altered manifestations of ST-elevation myocardial infarction (STEMI). However, a critical knowledge gap remains regarding the specific impact of COVID-19 on coronary angiographic characteristics in STEMI patients, posing challenges for optimizing treatment strategies. This study addresses this gap by systematically evaluating the angiographic features and procedural outcomes of STEMI patients with concurrent SARS-CoV-2 infection. Objectives This study compared coronary angiographic findings, procedural outcomes, and in-hospital events between STEMI patients with and without COVID-19 matched cohort design. We hypothesized that STEMI patients with SARS-CoV-2 infection have a thrombus burden, increased lesion complexity, and a greater prevalence of multi-vessel disease. Methods A retrospective matched cohort study was conducted at a tertiary medical center. A total of 85 STEMI patients with confirmed COVID-19 were matched in a 1:1 ratio with 85 COVID-19-negative STEMI patients based on age and baseline clinical characteristics. Blinded cardiologists performed coronary angiographic assessments, evaluating key parameters such as thrombus burden, lesion complexity, and the presence of multi-vessel disease. Procedural success was determined using TIMI flow grade, while in-hospital outcomes, including major adverse cardiac events (MACE) and mortality, were analyzed. Statistical comparisons employed t-tests, Chi-square tests, and multivariable logistic regression to account for potential confounders. Results ST-segment elevation MI patients with COVID-19 exhibited a significantly higher thrombus burden (3.4 ± 0.7 vs. 2.3 ± 0.8, p<0.001), increased lesion complexity (mean lesion length: 23.6 ± 5.2 mm vs. 19.8 ± 4.7 mm, p=0.002), and a greater prevalence of multi-vessel disease (38% vs. 20%, p=0.01). The success rates of interventions were lower among COVID-19-positive patients (81% vs. 92%, p=0.04). Multivariable logistic regression analysis identified COVID-19 as an independent predictor of high thrombus burden (OR 2.5; 95% CI: 1. 3) and multi-Vessel disease (OR 1.9; 95% CI: 1.2). Conclusions COVID-19 significantly influences coronary angiographic characteristics in STEMI patients, leading to a higher thrombus burden, increased lesion complexity, and a greater prevalence of multi-Vessel disease. These findings underscore the need for tailored interventional strategies and intensified antithrombotic therapy in this high-risk population to improve procedural success and in-hospital outcomes. COVID-19 STEMI Coronary Angiography Thrombus Burden Multi-Vessel Disease Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6339446","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":452384843,"identity":"ae8f1513-8ba1-4e05-99fc-832c0751f476","order_by":0,"name":"Ghorbani Mina","email":"","orcid":"","institution":"Babol University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Ghorbani","middleName":"","lastName":"Mina","suffix":""},{"id":452384844,"identity":"b1a4453e-294d-4d69-983a-9d99f2b2aef5","order_by":1,"name":"Jafaripour Iraj","email":"","orcid":"","institution":"Babol University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Jafaripour","middleName":"","lastName":"Iraj","suffix":""},{"id":452384845,"identity":"529617e0-d79c-4245-ae37-653c666c2413","order_by":2,"name":"Ziaie Naghmeh","email":"","orcid":"","institution":"Babol University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Ziaie","middleName":"","lastName":"Naghmeh","suffix":""},{"id":452384846,"identity":"207a1284-60ef-4e9c-9aaf-1f375bae8181","order_by":3,"name":"Saravi Mehrdad","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA8klEQVRIiWNgGAWjYFACHhBihrATKoAEM3MDKVrOgLQwkqKFsQ1M4tei29577MObGmt7/tmHn0k8nFcbzd8O1PKjYhtOLWZnziXPnHMsPXHGuTQzicRtx3NnHGZsYOw5cxu3lhs5xsw8bIcTGM4wGBskbjuW2wDUwszYhkfL/TdALf8O28ufYf9skDjnWO58glpu8Bgz87YdZtxwhsfwQWJDTe4GglrO5Bgzzu1LT9x4hqfwQcKxA7kbgVoO4vXL8TPGDG++WdvLnWHfcPBHTV3uvPOHDz74UYFbCzo4DCYPEK0eCOpIUTwKRsEoGAUjBAAAsAhdRhkdoscAAAAASUVORK5CYII=","orcid":"","institution":"Babol University of Medical Sciences","correspondingAuthor":true,"prefix":"","firstName":"Saravi","middleName":"","lastName":"Mehrdad","suffix":""}],"badges":[],"createdAt":"2025-03-30 16:08:13","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6339446/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6339446/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":90209557,"identity":"0a682eba-24b4-4ed9-a534-c089449e3f75","added_by":"auto","created_at":"2025-08-30 02:01:36","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":348217,"visible":true,"origin":"","legend":"","description":"","filename":"SaravimehrdadAssessingtheimpact.......pdf","url":"https://assets-eu.researchsquare.com/files/rs-6339446/v1_covered_8d7c76f5-f2e0-4cde-9436-9b308f45f1c1.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Assessing the Impact of COVID-19 on Angiographic Characteristics in Patients with ST- Elevation Myocardial Infarction: A Matched Cohort Analysis","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"COVID-19, STEMI, Coronary Angiography, Thrombus Burden, Multi-Vessel Disease","lastPublishedDoi":"10.21203/rs.3.rs-6339446/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6339446/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eBackground The COVID-19 pandemic has significantly influenced the presentation and management of cardiovascular disease, raising concerns regarding increased thrombotic events and altered manifestations of ST-elevation myocardial infarction (STEMI). However, a critical knowledge gap remains regarding the specific impact of COVID-19 on coronary angiographic characteristics in STEMI patients, posing challenges for optimizing treatment strategies. This study addresses this gap by systematically evaluating the angiographic features and procedural outcomes of STEMI patients with concurrent SARS-CoV-2 infection.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eObjectives This study compared coronary angiographic findings, procedural outcomes, and in-hospital events between STEMI patients with and without COVID-19 matched cohort design. We hypothesized that STEMI patients with SARS-CoV-2 infection have a thrombus burden, increased lesion complexity, and a greater prevalence of multi-vessel disease.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMethods A retrospective matched cohort study was conducted at a tertiary medical center. A total of 85 STEMI patients with confirmed COVID-19 were matched in a 1:1 ratio with 85 COVID-19-negative STEMI patients based on age and baseline clinical characteristics. Blinded cardiologists performed coronary angiographic assessments, evaluating key parameters such as thrombus burden, lesion complexity, and the presence of multi-vessel disease. Procedural success was determined using TIMI flow grade, while in-hospital outcomes, including major adverse cardiac events (MACE) and mortality, were analyzed. Statistical comparisons employed t-tests, Chi-square tests, and multivariable logistic regression to account for potential confounders.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eResults ST-segment elevation MI patients with COVID-19 exhibited a significantly higher thrombus burden (3.4 ± 0.7 vs. 2.3 ± 0.8, p\u0026lt;0.001), increased lesion complexity (mean lesion length: 23.6 ± 5.2 mm vs. 19.8 ± 4.7 mm, p=0.002), and a greater prevalence of multi-vessel disease (38% vs. 20%, p=0.01). The success rates of interventions were lower among COVID-19-positive patients (81% vs. 92%, p=0.04). Multivariable logistic regression analysis identified COVID-19 as an independent predictor of high thrombus burden (OR 2.5; 95% CI: 1. 3) and multi-Vessel disease (OR 1.9; 95% CI: 1.2).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eConclusions COVID-19 significantly influences coronary angiographic characteristics in STEMI patients, leading to a higher thrombus burden, increased lesion complexity, and a greater prevalence of multi-Vessel disease. These findings underscore the need for tailored interventional strategies and intensified antithrombotic therapy in this high-risk population to improve procedural success and in-hospital outcomes.\u003c/p\u003e","manuscriptTitle":"Assessing the Impact of COVID-19 on Angiographic Characteristics in Patients with ST- Elevation Myocardial Infarction: A Matched Cohort Analysis","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-05-07 07:20:21","doi":"10.21203/rs.3.rs-6339446/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"d7b740e9-9ff3-4372-83b7-b2d7f90e6bf5","owner":[],"postedDate":"May 7th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-08-30T01:53:29+00:00","versionOfRecord":[],"versionCreatedAt":"2025-05-07 07:20:21","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6339446","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6339446","identity":"rs-6339446","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}