SCAI 2026
COVID tied to higher mortality after severe heart attack
Clinical takeaway: COVID-19 may continue to worsen outcomes after a ST-elevation myocardial infarction (STEMI) well beyond the initial hospitalization, supporting closer follow-up in survivors.
An ST-elevation myocardial infarction (STEMI) is a severe heart attack caused by complete coronary artery blockage. While worse in-hospital outcomes with COVID-19 have already been reported, less has been known about whether that risk extends beyond the acute admission.
Patients with COVID-19 and a STEMI had 67% higher one-year mortality than patients without COVID-19, at 45% vs. 27%. Most deaths occurred during the initial hospitalization, but risk remained elevated after discharge. Among hospital survivors, one-year mortality was 12% in patients with COVID-19 vs. 9.6% in patients without COVID-19 and 5.3% in matched pre-pandemic controls.
Researchers analyzed 2,358 patients in the North American COVID-19 Myocardial Infarction registry, including patients who were COVID-19 positive, COVID-19 negative, and matched pre-pandemic controls. The analysis examined one-year outcomes after hospitalization for ST-elevation myocardial infarction.
The findings suggest COVID-19 may add lasting risk to an already high-risk cardiovascular event, not just worsen the early hospital course. Because this was an observational registry analysis, it cannot show which mechanisms drove the excess mortality or which follow-up strategies might reduce it.
“Our findings emphasize that patients who survive a STEMI need close, ongoing attention from their care team, especially when experiencing COVID-19,” said Payam Dehghani, MD, FSCAI, interventional cardiologist at Prairie Vascular Research Inc in Regina, Saskatchewan, Canada. “Clinicians should carefully assess and monitor cardiovascular risk factors, including lifestyle choices, and patients must remain actively engaged in their recovery and follow-up care.”
Source: Dehghani P. SCAI Scientific Sessions 2026. 2026 Apr 24. North American COVID-19 Myocardial Infarction Registry: One-Year Follow-Up