Findings from the North American COVID-19 Myocardial Infarction (NACMI) Registry show that patients with COVID-19 and ST-elevation myocardial infarction (STEMI) have significantly higher 1-year mortality rates than patients with STEMI alone. This registry is the first study to describe long-term outcomes for STEMI and COVID-19 patients. Researchers presented their latest data today at the Society of Cardiovascular Angiography and Interventions (SCAI) 2026 Scientific Sessions and Canadian Society of Interventional Cardiology/Consortium on Cardiac Interventions (CAIC-ACCI) Summit in Montreal.
COVID-19 can significantly worsen cardiovascular disease outcomes, and patients with pre-existing heart disease are at increased risk of complications, highlighting the need for heightened clinical vigilance during and after hospitalization. For example, patients who have both COVID-19 and STEMI, a severe heart attack caused by complete occlusion of a coronary artery, are seven times more likely to die in the hospital, have a stroke, experience a recurrent myocardial infarction, or have repeated unplanned revascularization than patients without COVID-19. However, the long-term impact of COVID-19 on this patient population is unknown.
SCAI and the Canadian Society of Interventional Cardiology (CAIC), in collaboration with the American College of Cardiology Intervention Council, collaborated to create the multicenter observational registry NACMI. NACMI is an investigator-led, multicenter, observational registry of hospitalized STEMI patients with confirmed or suspected COVID-19 infection in North America. This long-term follow-up substudy included a total of 2,358 STEMI patients with three subgroups: COVID-19 positive (n=623), COVID-19 negative (n=694), and matched controls (n=1,041).
The study found that patients with COVID-19 and STEMI had a 67% higher 1-year mortality rate compared to patients without COVID-19 (45% vs. 27%, respectively) (p<0.001). Most deaths (86%) occurred during the initial hospitalization. Among survivors of initial hospitalization, COVID-19 patients had a 25% higher 1-year mortality rate (12% vs. 9.6%) (p<0.001), more than double the pre-pandemic mortality rate (5.3%) (p<0.001).
Our findings highlight that patients who survive STEMI require continued close attention by their care team, especially if they have COVID-19. By partnering with CAIC, we were able to answer this important clinical question regarding long-term outcomes of coronavirus disease (COVID-19) and STEMI. Clinicians must carefully assess and monitor cardiovascular risk factors, including lifestyle choices, and patients must remain active in their recovery and follow-up care. ”
Dr. Payam Deghani, FSCAI, Interventional Cardiology Specialist at Prairie Vascular Research, Regina, Saskatchewan, Canada
The researchers note that additional analyzes are underway to investigate potential gender disparities between patients with COVID-19 and STEMI.
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Society of Cardiovascular Angiography and Interventions
