Higher rates of thrombolysis failure and stent thrombosis during the COVID-19 upsurges. What should we learn at recurrent waves
SAMIR, A., Gergis, M., ElBoraei, A., Wagdy, K., Osman, A., Hattal, K., Bahaa, H., Hosny, M., Hassan, A. (2024). Higher rates of thrombolysis failure and stent thrombosis during the COVID-19 upsurges. What should we learn at recurrent waves. EKB Journal Management System, 15(1), -. doi: 10.21608/tejhcr.2025.261143.1001
AHMAD SAMIR; Michael Gergis; Ahmed ElBoraei; Kerolos Wagdy; Ahmed Osman; Khaled Hattal; Hesham Bahaa; Mohamed Hosny; Ahmed Hassan. "Higher rates of thrombolysis failure and stent thrombosis during the COVID-19 upsurges. What should we learn at recurrent waves". EKB Journal Management System, 15, 1, 2024, -. doi: 10.21608/tejhcr.2025.261143.1001
SAMIR, A., Gergis, M., ElBoraei, A., Wagdy, K., Osman, A., Hattal, K., Bahaa, H., Hosny, M., Hassan, A. (2024). 'Higher rates of thrombolysis failure and stent thrombosis during the COVID-19 upsurges. What should we learn at recurrent waves', EKB Journal Management System, 15(1), pp. -. doi: 10.21608/tejhcr.2025.261143.1001
SAMIR, A., Gergis, M., ElBoraei, A., Wagdy, K., Osman, A., Hattal, K., Bahaa, H., Hosny, M., Hassan, A. Higher rates of thrombolysis failure and stent thrombosis during the COVID-19 upsurges. What should we learn at recurrent waves. EKB Journal Management System, 2024; 15(1): -. doi: 10.21608/tejhcr.2025.261143.1001

Higher rates of thrombolysis failure and stent thrombosis during the COVID-19 upsurges. What should we learn at recurrent waves

The Egyptian Journal of Hypertension and Cardiovascular Risk
Article 2, Volume 15, Issue 1, March 2024  XML PDF (676.43 K)
Document Type: Original Research
DOI: 10.21608/tejhcr.2025.261143.1001
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Authors
AHMAD SAMIR email orcid 1; Michael Gergis2; Ahmed ElBoraei1; Kerolos Wagdy2; Ahmed Osman1; Khaled Hattal3; Hesham Bahaa4; Mohamed Hosny1; Ahmed Hassan1
1Cardiovascular Medicine, Kasralainy Faculty of Medicine, Cairo University
2Aswan Heart Centre
3Helwan University
4National Heart Institute
Abstract
Background: On-site thrombolysis as an alternative to transfer for primary PCI (pPCI) was utilized during COVID-19 first peak in many localities enforced by the overwhelming burden on the unprepared health systems. However, higher rates of thrombolysis failure, and excess of STEMIs secondary to stent thrombosis were frequently reported during COVID-19 first peak, questioning a potential linkage to SARS-CoV-2-related prothrombotic status. The recent alarming spread by the new emerging SARS-CoV-2 variants in many regions threatens low- and middle-income countries by overwhelming crises similar to the commencement of the pandemic. In this retrospective analysis, we contrasted the clinical profiles, revascularization strategies and outcomes of STEMI patients presenting to our system during the first COVID-19 surge (n=37), to STEMI presentations in the same interval of the previous year (n=77), to inspect the impact of COVID-19 on STEMI presentations and outcomes.

Results: Patients’ profiles were mostly comparable between the COVID-19-era- and the control- groups. Compared to the controls, STEMI patients during the COVID-19-era had significantly higher rates of thrombolysis failure (5 (63%) vs 3 (21%), p = 0.05) and of STEMIs due to stent thrombosis (5 (16%) vs 2 (3%), p = 0.01).

Conclusions: A prevalent prothrombotic milieu parallels SARS-CoV-2 upsurges, disproportionately exceeding numbers of confirmed SARS-CoV-2 infections. This prothrombotic status probably enhanced stent thrombosis and reduced success of thrombolysis in STEMI cohorts. It is prudent to consider these observations in the unluckily event we faced recurrent upsurges dominated by the emerging SARS-CoV-2 variants.
Keywords
SARS-CoV-2; STEMI; thrombolysis; stents; Egypt
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