Initial Findings Published From the North American Cardiovascular COVID-19 Myocardial Infarction Registry

April 19, 2021—The Society for Cardiovascular Angiography & Interventions (SCAI) announced that initial findings from the North American Cardiovascular COVID-19 Myocardial Infarction (NACMI) Registry were published by Santiago Garcia, MD, et al in Journal of the American College of Cardiology (2021;77:1994-2003).

According to SCAI, NACMI is a collaboration of three cardiology societies. The registry sought to define baseline characteristics and management strategies and outcome data for COVID-positive patients presenting with ST-elevation myocardial infarction (STEMI). These results demonstrate COVID-positive patients with STEMI are a high-risk population with unique demographic and clinical characteristics resulting in an increased risk of mortality and stroke, advised SCAI.

Conducted under the guidance of the American College of Cardiology Interventional Council, Canadian Association of Interventional Cardiology, and SCAI, the registry enrolled 1,185 patients presenting with ST-segment elevation at 64 sites across the United States and Canada. Three groups of patients were included in the registry: COVID-positive patients; suspected positive or person under investigation; and a matched control group from a large STEMI registry.

“Our findings indicate that Black and Hispanic COVID-positive patients and those with diabetes mellitus more frequently presented with STEMI,” commented Dr. Garcia in the SCAI press release. “COVID-positive patients with ST-elevation have a very high in-hospital mortality rate of 33%. Fortunately, most patients received primary percutaneous coronary intervention (PPCI) with very small treatment delays (approximately, 15 minutes) despite the pandemic.”

As noted by SCAI, many patients in the registry presented with respiratory symptoms rather than chest pain, and cardiogenic shock was common (18%), which likely contributes to the high fatality rate. The study also showed that 23% of patients had “no clear culprit” artery and may represent different reasons for ST-segment elevation including microthrombi, myocarditis, or takotsubo cardiomyopathy.

Timothy Henry, MD, who is president-elect of SCAI and chair of the study, stated in the SCAI announcement, “This is the largest registry of COVID-positive patients presenting with STEMI. These results clearly illustrate the challenges and uniqueness of this patient population that deserves prompt and special attention. The rapid development of this ongoing, critically important prospective registry reflects the strong and unique collaboration of all three societies. It was gratifying to be part of this process and hopefully, the results will improve the care of our patients and stimulate further research.”

More information about the NACMI registry is available online at the SCAI COVID-19 Resource Center.