Skip to main content

Research Repository

Advanced Search

Outcomes of COVID-19 Positive Acute Coronary Syndrome Patients; a multisource Electronic Healthcare Records Study from England.

Rashid, Muhammad; Wu, Jianhua; Timmis, Adam; Curzen, Nick; Clarke, Sarah; Zaman, Azfar; Nolan, James; Shoaib, Ahmad; Mohamed, Mohamed O; de Belder, Mark A.; Deanfield, John; Gale, Chris P.; Mamas, Mamas A.

Outcomes of COVID-19 Positive Acute Coronary Syndrome Patients; a multisource Electronic Healthcare Records Study from England. Thumbnail


Authors

Jianhua Wu

Adam Timmis

Nick Curzen

Sarah Clarke

Azfar Zaman

Ahmad Shoaib

Mohamed O Mohamed

Mark A. de Belder

John Deanfield

Chris P. Gale



Abstract

BACKGROUND: Patients with underlying cardiovascular disease and Coronavirus disease 2019 (COVID-19) infection are at increased risk of morbidity and mortality.

OBJECTIVES: This study was designed to characterise the presenting profile and outcomes of patients hospitalized with acute coronary syndrome (ACS) and COVID-19 infection.

METHODS: This observational cohort study was conducted using multisource data from all acute NHS hospitals in England. All consecutive patients hospitalized with diagnosis of ACS with or without COVID-19 infection between 1st March- 31st May 2020 were included. The primary outcome was in-hospital and 30-day mortality.

RESULTS: A total of 12,958 patients were hospitalized with ACS during the study period, of which 517 (4.0%) were COVID-19 positive and were more likely to present with non-ST elevation acute myocardial infarction. COVID-19 ACS group were generally older, Black Asian and Minority ethnicity, more comorbid and had unfavourable presenting clinical characteristics such as elevated cardiac troponin, pulmonary oedema, cardiogenic shock and poor left ventricular systolic function compared with non-COVID-19 ACS group. They were less likely to receive an invasive coronary angiography (67.7% vs 81.0%), percutaneous coronary intervention (PCI) (30.2% vs 53.9%) and dual antiplatelet medication (76.3% vs 88.0%). After adjusting for all the baseline differences, patients with COVID-19 ACS had higher in-hospital (adjusted odds ratio (aOR) 3.27 95% confidence interval (CI) 2.41-4.42) and 30-day mortality (aOR 6.53 95%CI 5.1-8.36) compared to the non COVID-19 ACS group.

CONCLUSION: COVID-19 infection was present in 4% of patients hospitalized with an ACS in England and is associated with lower rates of guideline recommended treatment and significant mortality hazard.

Journal Article Type Article
Acceptance Date Dec 7, 2020
Online Publication Date Mar 13, 2021
Publication Date Jan 19, 2021
Publicly Available Date Mar 29, 2024
Journal Journal of Internal Medicine
Print ISSN 0954-6820
Publisher Wiley
Volume 290
Issue 1
Pages 88-100
DOI https://doi.org/10.1111/joim.13246
Keywords acute coronary syndrome, coronavirus disease 2019, England, mortality, pandemic
Publisher URL https://onlinelibrary.wiley.com/doi/10.1111/joim.13246