the pragmatic role of covid-19 on the thrombus grade of patients with contemporary st-segment-elevation myocardial infarction

Background: limited data exist on the clinical outcomes of patients with coronavirus disease 2019 (covid-19) presenting with st-segment-elevation myocardial infarction (stemi). methods: this multicenter study, conducted in 6 centers in iran, aimed to compare baseline clinical and procedural data between a case group, comprising stemi patients with covid-19, and a control group, comprising stemi patients before the covid-19 pandemic, and to determine in-hospital infarct-related artery thrombus grades and major adverse cardiocerebrovascular events (macces), defined as a composite of deaths from any cause (cardiovascular and noncardiovascular), nonfatal strokes, and stent thrombosis. results: no significant differences were observed between the 2 groups regarding baseline characteristics. primary percutaneous coronary intervention (ppci) was performed in 72.9% of the cases and 98.5% of the controls (p=0.043), and primary coronary artery bypass grafting was performed in 6.2% of the cases and 1.4% of the controls (p=0.048). successful ppci procedures (final timi flow grade iii) were significantly fewer in the case group (66.5% vs 93.5%; p=0.001). the baseline thrombus grade before wire crossing was not statistically significantly different between the 2 groups. the summation of thrombus grades iv and v was 75% in the case group and 82% in the control group (p=0.432). the rate of macces was 14.5% and 2.1% in the case and control groups, respectively (p=0.002). conclusion: in our study, the thrombus grade had no significant differences between the case and control groups; however, the in-hospital rates of the no-reflow phenomenon, periprocedural mi, mechanical complications, and macces were statistically significantly higher in the case group.