key: cord-312519-31mrmgmk
authors: Dauerman, Harold L.
title: The Unbearable Thrombus of COVID-19: Primary PCI, Thrombus, and COVID-19
date: 2020-09-08
journal: J Am Coll Cardiol
DOI: 10.1016/j.jacc.2020.07.027
sha: 
doc_id: 312519
cord_uid: 31mrmgmk

[Figure: see text]

for patients with an acute culprit lesion, are there unique features of the PCI procedure that warrant caution and concern? Via detailed angiographic comparison to a COVID-19-negative control group, they observed a dramatic increase in thrombus burden that may compliment prior insights into the pathophysiology of the COVID-19 pandemic.

The inclusion criteria of COVID-19 STEMI registries vary widely: some include COVID-19-positive patients, some do not. And, the pathophysiology in 

76, NO. 10, 2020

Multivessel thrombosis was seen in 17.9% of COVID-19 STEMI patients compared with none of the COVID-19-negative patients, as seen in a prior case report (7); stent thrombosis as the initial presentation was also 10 times more likely (p < 0.05 for both comparisons). to the virus can be measured by multiple serological parameters including C-reactive protein and D-dimer (12) . The connection between inflammation and thrombosis is previously established and occurs via activation of leukocytes, platelets, endothelium, and smooth muscle cells (13) . Furthermore, the association of viral infection and enhanced risk of myocardial infarction has been described with respect to influenza, and an inflammatory mediation of risk is plausible (14, 15 

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both epicardial and myocardial perfusion

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Risk of ischemic stroke in patients with coronavirus disease 2019 (COVID-19) vs patients with influenza