COVID-19 patients with STEMI show higher one-year mortality rates

Findings from the North American COVID-19 Myocardial Infarction (NACMI) registry demonstrate significantly higher one-year mortality rates in patients with COVID-19 and ST-elevation myocardial infarction (STEMI) compared to patients with STEMI alone. This registry is the first study to describe long-term outcomes in patients with STEMI and COVID-19. Researchers presented the late-breaking data today at the Society for Cardiovascular Angiography & Interventions (SCAI) 2026 Scientific Sessions & Canadian Association of Interventional Cardiology/Association Canadienne de cardiologie d'intervention (CAIC-ACCI) Summit in Montreal.

COVID-19 can significantly worsen cardiovascular outcomes, placing patients with preexisting heart conditions at increased risk for complications, underscoring the need for heightened clinical vigilance during and after hospitalization. For example, patients who experience COVID-19 and STEMI, a severe type of heart attack caused by a complete blockage of a coronary artery, are seven times more likely to experience in-hospital death, stroke, recurrent myocardial infarction, or repeat unplanned revascularization, compared to those who did not have COVID-19. However, the long-term effects of COVID-19 on this patient population are unknown.

SCAI and the Canadian Association of Interventional Cardiology (CAIC), in conjunction with the American College of Cardiology Interventional Council, collaborated to create the multi-center observational registry, NACMI. NACMI is a prospective, investigator-initiated, multicenter, observational registry of hospitalized STEMI patients with confirmed or suspected COVID-19 infection in North America. This long-term follow-up sub-study 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).

This study found patients with COVID-19 and STEMI had a 67% higher one-year mortality rate compared to patients who did not have COVID-19 (45% vs. 27%, respectively) (p<0.001). Most deaths (86%) occurred during the initial hospital stay. Among survivors of initial hospitalization, one-year mortality rates were 25% higher in patients with COVID-19 (12% vs. 9.6%) (p<0.001) and more than double the pre-pandemic rate (5.3%) (p<0.001). 

Our findings emphasize that patients who survive a STEMI need close, ongoing attention from their care team, especially when experiencing COVID-19. By partnering with CAIC, we were able to answer this critical clinical question around the long-term outcomes of COVID-19 and STEMI. 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." 

Payam Dehghani, MD, FSCAI, interventional cardiologist at Prairie Vascular Research Inc in Regina, Saskatchewan, Canada

The researchers note that additional analyses exploring potential gender disparities among patients with COVID-19 and STEMI are underway.