The North American COVID-19 STEMI registry (NACMI) is a collaboration between the Society for Cardiovascular Angiography and Interventions, the American College of Cardiology Interventional Council, and the Canadian Association of Interventional Cardiology. It is a prospective multi center observational registry of hospitalized STEMI patients with COVID-19 infection. Patients were enrolled from March 1, 2020, to December 31, 2021. It was developed to determine the demographics, treatment, and outcomes for patients with STEMI who had COVID-19 infection. The trends and results were presented from this registry at the annual meeting of the American College of Cardiology in April 2022. A subset of this study involving the analysis of gender differences in patients with STEMI also suffering from COVID-19, was presented at the annual meeting of Society for Coronary Angiography and Interventions in May 2022.  

Why is this study important?  

  • This study is important because the morbidity and mortality of STEMI patients with COVID-19 is markedly elevated compared to STEMI patients without COVID-19. 
  • In addition, it is well known that women with STEMI who do not have COVID-19, have increased morbidity and mortality, present with different initial demographics, and receive different treatment strategies compared with a male cohort. 
  • The effect of COVID-19 on women versus men presenting with STEMI has not been previously determined. 

What questions was this study designed to answer? 

  • This study was designed to determine the effect on COVID-19 on women versus men presenting with STEMI. 
  • It was also designed to assess differences in demographics, outcomes and treatment strategies in women versus men with STEMI and COVID-19 infection. 

What did the study show? 

  • Of the 585 patients with STEMI and COVID-19 infection, 26% were female and 74% were men. 
  • Women were significantly older, had higher rates of diabetes, stroke, and statin use on admission. 
  • Women were less likely to present with chest pain versus men, at 47% versus 59% respectively. 
  • Women presenting with STEMI were less likely to have identifiable culprit lesion, at 67% versus 82%, on coronary angiography 

All authors: Gary S. Ledley, MD, FSCAI 

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