NACMI Registry Shows Lower In-Hospital Mortality for STEMI Patients with COVID-19 in 2021

April 4, 2022—The Society for Cardiovascular Angiography & Interventions (SCAI) announced that new findings showed a 25% reduction in early mortality in year 2021 compared to 2020 among patients with ST-segment elevation myocardial infarction (STEMI) and COVID-19 infection and zero deaths for patients vaccinated against SARS-CoV-2. The data were from the North American COVID-19 STEMI (NACMI) registry, which is a collaboration of SCAI, the American College of Cardiology (ACC), and the Canadian Association of Interventional Cardiology (CAIC).

The registry was established in 2020 to define baseline characteristics, management strategies, and outcome data for COVID-positive patients presenting with STEMI. Sixty-four medical centers across North America and Canada contributed data to the registry.

The results were presented by Santiago Garcia, MD, during the ACC.22 annual scientific session and published online by Dr. Garcia et al in the Journal of the American College of Cardiology.

According to SCAI, the initial findings showed that 33% of North American patients with both COVID-19 and a STEMI died in the hospital. In the current study, patients who in 2020 were positive for COVID-19 and had experienced a STEMI were compared with patients treated in 2021 who had received vaccination against SARS-CoV-2.

The registry examined 586 patients, 227 who were treated in 2020 before vaccinations were made available and 359 in 2021 after emergency use authorization from the FDA. Of the patient population, more than 70% were male, approximately 75% were aged ≥ 55 years, approximately 70% had high blood pressure, and approximately 45% were diabetic. Compared to 2020, the proportion of Caucasian patients was higher, and patients presented more frequently with typical ischemic symptoms.

The investigators found that survival was significantly better with mortality decreasing from 33% in 2020 to 23% in 2021. Also, patients treated in 2021 who were vaccinated were less likely to experience severe respiratory illness. There were no hospital deaths among the population, while patients who were unvaccinated experienced a higher death rate (22%).

“The management and outcomes of STEMI patients with COVID-19 infection during the pandemic is evolving towards that of STEMI patients prior to the pandemic although mortality remains high for unvaccinated patients,” commented Dr. Garcia in the SCAI press release.

Timothy D. Henry, MD, President of SCAI and Study Chair, added, “NACMI is a unique collaboration between SCAI, ACC, and CAIC that has allowed us to develop the largest registry of STEMI in patients with COVID-19 in the world. The unique insights from NACMI enable us to improve care for these high-risk patients.”