Myocardial infarction in patients with COVID-19, a complication to take into account.

Geordan Goire Guevara


COVID-19 has been associated with various cardiovascular complications including acute myocardial injury, myocarditis, arrhythmias, and venous thromboembolism. The infection is severe in patients with pre-existing cardiovascular disease, and a systemic inflammatory response due to a cytokine storm in severe COVID-19 cases can lead to acute myocardial infarction. The prognosis and clinical evolution can be deleterious in patients with COVID-19 who have these vascular complications, highlighting an acute need to determine the magnitude of cardiovascular complications and identify populations at risk to anticipate complications. Here, we report two cases of ST-elevation myocardial infarction (STEMI), a 27-year-old male with no coronary risk factors and a 63-year-old male with past medical history of hypertension and smoker, both of them were COVID-19-positive and hospitalized with respiratory symptoms as well.



GBD 2017 Causes of Death Collaborators Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018;392:1736–1788. [PMC free article] [PubMed] [Google Scholar]

Thygesen K., Alpert J.S., Jaffe A.S. Fourth universal definition of myocardial infarction (2018) J Am Coll Cardiol. 2018;72:2231–2264. [PubMed] [Google Scholar]

Libby P., Loscalzo J., Ridker P.M. Inflammation, immunity, and infection in atherothrombosis: JACC Review Topic of the Week. J Am Coll Cardiol. 2018;72:2071–2081. [PMC free article] [PubMed] [Google Scholar]

Mogensen T.H. Pathogen recognition and inflammatory signaling in innate immune defenses. Clin Microbiol Rev. 2009;22:240–273. [PMC free article] [PubMed] [Google Scholar]

van de Veerdonk F.L., Netea M.G., Dinarello C.A., Joosten L.A. Inflammasome activation and IL-1beta and IL-18 processing during infection. Trends Immunol. 2011;32:110–116. [PubMed] [Google Scholar]

Vallance P., Collier J., Bhagat K. Infection, inflammation, and infarction: does acute endothelial dysfunction provide a link? Lancet. 1997;349:1391–1392. [PubMed] [Google Scholar]

Welt FGP, Shah P.B., Aronow H.D. Catheterization laboratory considerations during the coronavirus (COVID-19) pandemic: from the ACC’s Interventional Council and SCAI. J Am Coll Cardiol. 2020;75:2372–2375. [PMC free article] [PubMed] [Google Scholar]

Mahmud E., Dauerman H.L., Welt F.G. Management of acute myocardial infarction during the COVID-19 pandemic. J Am Coll Cardiol. 2020 Apr 21 [E-pub ahead of print] [PMC free article] [PubMed] [Google Scholar]

Szerlip M., Anwaruddin S., Aronow H.D. Considerations for cardiac catheterization laboratory procedures during the COVID-19 pandemic perspectives from the Society for Cardiovascular Angiography and Interventions Emerging Leader Mentorship (SCAI ELM) Members and Graduates. Catheter Cardiovasc Interv. 2020 Mar 25 [E-pub ahead of print] [PubMed] [Google Scholar]

Lim W., Qushmaq I., Devereaux P.J. Elevated cardiac troponin measurements in critically ill patients. Arch Intern Med. 2006;166:2446–2454. [PubMed] [Google Scholar]

Sarkisian L., Saaby L., Poulsen T.S. Prognostic impact of myocardial injury related to various cardiac and noncardiac conditions. Am J Med. 2016;129:506–514.e1. [PubMed] [Google Scholar]

Sarkisian L., Saaby L., Poulsen T.S. Clinical characteristics and outcomes of patients with myocardial infarction, myocardial injury, and nonelevated troponins. Am J Med. 2016;129:446.e5–446.e21. [PubMed] [Google Scholar]

Smeeth L., Thomas S.L., Hall A.J., Hubbard R., Farrington P., Vallance P. Risk of myocardial infarction and stroke after acute infection or vaccination. N Engl J Med. 2004;351:2611–2618. [PubMed] [Google Scholar]

Harrington R.A. Targeting inflammation in coronary artery disease. N Engl J Med. 2017;377:1197–1198. [PubMed] [Google Scholar]

Kwong J.C., Schwartz K.L., Campitelli M.A. Acute myocardial infarction after laboratory-confirmed influenza infection. N Engl J Med. 2018;378:345–353. [PubMed] [Google Scholar]

Xiong TY, Redwood S, Prendergast B, Chen M. Coronaviruses and the cardiovascular system: Acute and long-term implications. Eur Heart J. 2020;41(19):1798–800. [PMC free article] [PubMed] [Google Scholar]

Driggin E, Madhavan MV, Bikdeli B, et al. Cardiovascular considerations for patients, health care workers, and health systems during the COVID-19 pandemic. J Am Coll Cardiol. 2020;75(18):2352–71. [PMC free article] [PubMed] [Google Scholar]

Bangalore S, Sharma A, Slotwiner A, et al. ST-segment elevation in patients with COVID-19 – A case series. N Engl J Med. 2020;382(25):2478–80. [PMC free article] [PubMed] [Google Scholar]

Tan YK Goh C Leow AST et al. COVID-19 and ischemic stroke: a systematic review and meta-summary of the literature. J Thromb Thrombolysis. 2020; 50: 587-595.

Li Y Li M Wang M et al. Acute cerebrovascular disease following COVID-19: a single center, retrospective, observational study. Stroke Vasc Neurol. 2020; 5: 279-284.

Lodigiani C Iapichino G Carenzo L et al. Venous and arterial thromboembolic complications in COVID-19 patients admitted to an academic hospital in Milan, Italy. Thromb Res. 2020; 191: 9-14.

Bilaloglu S Aphinyanaphongs Y Jones S Iturrate E Hochman J Berger JS. Thrombosis in hospitalized patients with COVID-19 in a New York City health system. JAMA. 2020; 324: 799-801.

Modin D Claggett B Sindet-Pedersen C et al. Acute COVID-19 and the incidence of ischemic stroke and acute myocardial infarction. Circulation. 2020; 142: 2080-2082.

Birnbaum Y, Sclarvosky S, Ben-Ami R, et al. Polymorphous ventricular tachycardia early after acute myocardial infarction. Am J Cardiol1993; 71:745–9.

Cross Ref PubMed Web of Science Google Scholar

Tomcsányi J, Marosi A, Bózsik B, et al. N-Terminal pro-brain natriuretic peptide and tombstoning ST-segment elevation in patients with anterior wall acute myocardial infarction. Am J Cardiol. 2005;96:1197–9. [PubMed] [Google Scholar]

Enlaces refback

  • No hay ningĂşn enlace refback.

Licencia de Creative Commons
Esta obra está bajo una licencia de Creative Commons Reconocimiento-NoComercial-SinObraDerivada 4.0 Internacional.