Impact of COVID-19 Pandemic on STEMI Networks in Central Romania

The COVID-19 pandemic has had a major impact on cardiovascular emergencies. The aim of this study was to investigate the impact of the COVID-19 pandemic on a regional network for management of ST-segment elevation acute myocardial infarction (STEMI). Methods: We report a single center’s experience of patients hospitalized for ACS in a high-volume hub of a STEMI network during the lockdown (in the first pandemic trimester), compared with the same time interval of the previous year and including all consecutive patients referred for an AMI during the second trimester of 2020 (from April to June) or during the same time interval of the previous year, 2019. Results: The absolute number of hospital admissions for AMI decreased by 22.3%, while the non-AMI hospitalizations decreased by 77.14% in Q2-2020 compared to Q2-2019 (210 vs. 48, p < 0.0001). As a consequence, the percentage of AMI cases from the total number of hospital admission increased from 38% to 68% (p < 0.0001), AMI becoming the dominant pathology. In the STEMI group there was a significant reduction of 55% in the absolute number of late STEMI presentations. Functionality of the STEMI network at the hub level did not present a significant alteration with only a minor increase in the door-to-balloon time, from 34 min to 41 min. However, at the level of the network we recorded a lower number of critical cases transferred to the interventional center, with a dramatic reduction of 56.1% in the number of critical STEMI cases arriving in the acute cardiac care unit (17.0% vs. 7.3%, p-0.04 for KILLIP class III, and 21.17% vs. 11.11%, p = 0.08 for resuscitated out of hospital cardiac arrest). Conclusions: The COVID-19 outbreak did not have a major impact on the interventional center’s functionality, but it limited the capacity of the regional STEMI network to bring the critical patient with complicated STEMI to the cathlab in time during the first months of the lockdown. Even a very well-functioning STEMI network like the one in Central Romania had difficulties bringing the most critical STEMI cases to the cathlab in time.

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The impact of asthma in Brazil: a longitudinal analysis of data from a Brazilian national database system

Jornal Brasileiro de Pneumologia ◽

10.1590/s1806-37562016000000352 ◽

2017 ◽

Vol 43 (3) ◽

pp. 163-168 ◽

Cited By ~ 28

Author(s):

Thiago de Araujo Cardoso ◽

Cristian Roncada ◽

Emerson Rodrigues da Silva ◽

Leonardo Araujo Pinto ◽

Marcus Herbert Jones ◽

...

Keyword(s):

Hospital Mortality ◽

Hospital Admissions ◽

Indirect Costs ◽

Mortality Rates ◽

Absolute Number ◽

Public Health Care ◽

National Database ◽

Hospitalization Costs ◽

The Absolute ◽

The Impact

ABSTRACT Objective: To present official longitudinal data on the impact of asthma in Brazil between 2008 and 2013. Methods: This was a descriptive study of data collected between 2008 and 2013 from an official Brazilian national database, including data on asthma-related number of hospitalizations, mortality, and hospitalization costs. A geographical subanalysis was also performed. Results: In 2013, 2,047 people died from asthma in Brazil (5 deaths/day), with more than 120,000 asthma-related hospitalizations. During the whole study period, the absolute number of asthma-related deaths and of hospitalizations decreased by 10% and 36%, respectively. However, the in-hospital mortality rate increased by approximately 25% in that period. The geographic subanalysis showed that the northern/northeastern and southeastern regions had the highest asthma-related hospitalization and in-hospital mortality rates, respectively. An analysis of the states representative of the regions of Brazil revealed discrepancies between the numbers of asthma-related hospitalizations and asthma-related in-hospital mortality rates. During the study period, the cost of asthma-related hospitalizations to the public health care system was US$ 170 million. Conclusions: Although the numbers of asthma-related deaths and hospital admissions in Brazil have been decreasing since 2009, the absolute numbers are still high, resulting in elevated direct and indirect costs for the society. This shows the relevance of the burden of asthma in middle-income countries.

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Acute coronary syndrome in COVID-19 times: could it be business as usual?

European Heart Journal Acute Cardiovascular Care ◽

10.1093/ehjacc/zuab020.070 ◽

2021 ◽

Vol 10 (Supplement_1) ◽

Author(s):

J Ferreira ◽

M Fonseca ◽

JM Farinha ◽

AF Esteves ◽

A Pinheiro ◽

...

Keyword(s):

Acute Coronary Syndrome ◽

Hospital Admissions ◽

District Hospital ◽

Control Period ◽

Clinical Activity ◽

Class Iii ◽

Killip Class ◽

Coronary Syndrome ◽

Low Prevalence ◽

The Impact

Abstract Funding Acknowledgements Type of funding sources: None. Background In an attempt to cope with the COVID-19 pandemic, several measures of social distancing and reorganization of health care systems have been adopted. In Portugal, these included suspending elective clinical activity and a temporary national lockdown. Data from multiple centres, including central hospitals in Portugal, has shown a reduction in hospital admissions for acute coronary syndrome (ACS) during the COVID-19 outbreak. Fear of going to the hospital and physical inactivity have been pointed as possible explanations. Purpose to assess the impact of this pandemic and the measures taken against it on the pattern of admissions and treatment of patients with ACS in a district hospital. Methods A single-centre retrospective study was conducted in the Cardiology Department of a Portuguese district hospital, capable of performing 24h percutaneous coronary intervention. We analyzed the admissions for ACS during the peak of the first COVID-19 outbreak in Portugal (16th of March to 3rd of May 2020, coinciding with the suspension of elective activity) and compared it with two control periods: one immediately preceding the study period (27th of January to 15th of March - 2020 control) and one exactly one year before (16th of March to 3rd of May 2019 - 2019 control). Results During the 7 weeks of the first COVID-19 outbreak, 46 patients were hospitalized for ACS in our department, while 54 had been admitted during the 2020 control period and 40 in the 2019 control period, with a mean of 7 admissions/week (vs 8 and 6, respectively; p > 0.05). There were no significant differences between the study group and both controls regarding basal characteristics. Their presentation did not differ: the majority of patients (57%) was admitted for ST-elevation myocardial infarction and median time from symptom onset to admission to the emergency room was 3 hours, with 4% of patients presenting in Killip class ≥III (p > 0.05 for all). We also found no significant differences in the treatment administered nor in the outcomes (96% submitted to coronary angiography, median length of hospitalization of 4 days and in-hospital mortality rate of 2%, p > 0.05 for all). Conclusions Our study suggests that the reduction in admissions for ACS during the COVID-19 outbreak is not universal. Additionally, severity at presentation, treatment administered and outcomes did not seem to differ. The relatively low prevalence of COVID-19 in our hospital"s region might be the cause, since people might fear and refrain less from going to the hospital. Larger studies with other centres in low-prevalence regions are needed to confirm this hypothesis.

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The Impact of Age and Gender on Hematopoietic Stem Cells and Immune Contexture of the Bone Marrow Microenvironment

Cells Tissues Organs ◽

10.1159/000510774 ◽

2020 ◽

pp. 1-6

Author(s):

Rebar N. Mohammed

Keyword(s):

Stem Cells ◽

Bone Marrow ◽

Hematopoietic Stem Cells ◽

Immune Cells ◽

Absolute Number ◽

Cell Number ◽

Hematopoietic Stem ◽

The Absolute ◽

And Gender ◽

The Impact

Hematopoietic stem cells (HSCs) are a rare population of cells that reside mainly in the bone marrow and are capable of generating and fulfilling the entire hematopoietic system upon differentiation. Thirty-six healthy donors, attending the HSCT center to donate their bone marrow, were categorized according to their age into child (0–12 years), adolescence (13–18 years), and adult (19–59 years) groups, and gender into male and female groups. Then, the absolute number of HSCs and mature immune cells in their harvested bone marrow was investigated. Here, we report that the absolute cell number can vary considerably based on the age of the healthy donor, and the number of both HSCs and immune cells declines with advancing age. The gender of the donor (male or female) did not have any impact on the number of the HSCs and immune cells in the bone marrow. In conclusion, since the number of HSCs plays a pivotal role in the clinical outcome of allogeneic HSC transplantations, identifying a younger donor regardless the gender is critical.

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Age independently predicts hemodynamic, but not arrhythmic STEMI-related complications. Data from a cohort study on 848 STEMI patients

European Heart Journal Acute Cardiovascular Care ◽

10.1093/ehjacc/zuab020.065 ◽

2021 ◽

Vol 10 (Supplement_1) ◽

Author(s):

RC Serban ◽

L Hadadi ◽

I Sus ◽

EK Lakatos ◽

Z Demjen ◽

...

Keyword(s):

Heart Failure ◽

Coronary Intervention ◽

Hospital Death ◽

High Risk Population ◽

Time Interval ◽

Killip Class ◽

St Segment Elevation ◽

Catheterization Laboratory ◽

Cardiac Stimulation ◽

Cardiac Catheterization Laboratory

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Romanian Ministry of Education and Research, CNCS-UEFISCDI BACKGROUND Age is one of the most relevant prognostic factors in patients presenting with ST-segment elevation myocardial infarction (STEMI). However, it remains unknown whether this impaired prognosis is due to the occurrence of hemodynamic and/or arrhythmic STEMI-related complications. Understanding the mechanisms involved in STEMI-related complications with advancing age could significantly improve outcomes in this high-risk population. PURPOSE We aimed to investigate the contribution of advanced age to the occurrence of hemodynamic and arrhythmic complications in STEMI patients. METHODS A total of 848 consecutive patients treated by primary percutaneous coronary intervention for STEMI were evaluated. Heart failure, cardiogenic shock, asystole, inotropic and diuretic use, and kidney dysfunction were used as in-hospital markers of hemodynamic complications. Ventricular fibrillation, conduction disorders, cardiac stimulation, and antiarrhythmic drugs use were used as markers of arrhythmic complications. The relationship between age and the occurrence of hemodynamic and arrhythmic complications was evaluated. The contribution of age to in-hospital death was also assessed. RESULTS In-hospital death occurred in 50 (5.8%) patients; patients who deceased were significantly older than their non-deceased counterparts (70.9 ± 10.9 vs. 61.2 ± 11.8 years; p< 0.0001). There was no association between age and the occurrence of any of the evaluated arrhythmic complications (all p >0.05). However, patients who presented hemodynamic complications were significantly older than those who did not (all p< 0.05). Age >60 years was a significant predictor of hemodynamic complications (p< 0.0001) with 61.7% sensitivity and 60.4% specificity. The association between age and hemodynamic complications remained significant after correction for additional risk factors (i.e., hypertension, diabetes mellitus, pre-existing heart failure, Killip class on admission, symptom onset-to-cardiac catheterization laboratory time interval). CONCLUSIONS In the present study, age was identified as an independent predictor of STEMI-related hemodynamic, but not arrhythmic complications. These data indicate that whereas age does not seem to affect the occurrence of STEMI-related rhythm disorders, patients above the age of 60 should particularly benefit from closer follow-up and more intensive strategies to prevent life-threating hemodynamic complications.

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Impact of Monovalent Rotavirus Vaccine on Rotavirus Hospitalizations among Children Younger Than 5 Years of Age in the Ouest and Artibonite Departments, Haiti, 2013 to 2019

American Journal of Tropical Medicine and Hygiene ◽

10.4269/ajtmh.21-0414 ◽

2021 ◽

Author(s):

Anne-Marie Desormeaux ◽

Eleanor Burnett ◽

Gérard Joseph ◽

Mentor Ali Ber Lucien ◽

Negar Aliabadi ◽

...

Keyword(s):

Negative Binomial ◽

Hospital Admissions ◽

Absolute Number ◽

Sensitivity Analyses ◽

Rotavirus Vaccine ◽

Vaccine Introduction ◽

Rotavirus Vaccination ◽

Before And After ◽

Rotavirus Diarrhea ◽

The Impact

Rotavirus is responsible for 26% of diarrheal deaths in Latin America and the Caribbean. Haiti introduced the monovalent rotavirus vaccine in April 2014. The objective of this analysis is to describe the impact of the rotavirus vaccine on hospitalizations among Haitian children younger than 5 years old during the first 5 years after introduction. This analysis includes all children with diarrhea who were enrolled as part of a sentinel surveillance system at two hospitals from May 2013 to April 2019. We compare the proportion of rotavirus-positive specimens in each post-vaccine introduction year to the pre-vaccine period. To account for the potential dilution of the proportion of rotavirus-positive specimens from a waning cholera outbreak, we also analyzed annual trends in the absolute number of positive stools, fit a two-component finite-mixture model to the negative specimens, and fit a negative binomial time series model to the pre-vaccine rotavirus-positive specimens to predict the number of rotavirus diarrhea hospital admissions in the absence of rotavirus vaccination. The overall percentage of rotavirus-positive specimens declined by 22% the first year after introduction, increased by 17% the second year, and declined by 33% to 50% the subsequent 3 years. All sensitivity analyses confirmed an overall decline. We observed a clear annual rotavirus seasonality before and after vaccine introduction, with the greatest activity in December through April, and a biennial pattern, with high sharp peaks and flatter longer periods of increased rotavirus activity in alternating years, consistent with suboptimal vaccination coverage. Overall, our study shows evidence that the introduction of the rotavirus vaccine reduced the burden of severe rotavirus diarrhea.

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Temporal trend and regional disparity in osteoarthritis hospitalisations in Sweden 1998–2015

Scandinavian Journal of Public Health ◽

10.1177/1403494818766785 ◽

2018 ◽

Vol 47 (1) ◽

pp. 53-60 ◽

Cited By ~ 2

Author(s):

Aliasghar A Kiadaliri ◽

Giulia Rinaldi ◽

L Stefan Lohmander ◽

Ingemar F Petersson ◽

Martin Englund

Keyword(s):

Temporal Trend ◽

Hospital Admissions ◽

Weighted Mean Difference ◽

Age Groups ◽

Absolute Number ◽

Primary Diagnosis ◽

Regional Disparities ◽

Trend Test ◽

Knee Oa ◽

The Absolute

Aim: This study investigated time trend and regional disparities in hospitalisations due to osteoarthritis (OA) among people aged ≥20 years in Sweden from 1998 through 2015. Methods: National and regional data on hospital admissions with a primary diagnosis of OA were collected from the National Patient Register. The absolute and relative regional disparities were assessed using the absolute weighted mean difference from overall mean and the index of disparity. We applied joinpoint regression for temporal trend analysis of hospitalisations and the Mann–Kendall trend test for disparity measures. Changes in number of OA hospitalisations between 1998–2000 and 2013–2015 were analysed using two counterfactual scenarios. Results: During 1998–2015, OA hospitalisations constituted 2.0% of all hospitalisations, with higher proportions among women (58.7%) and those aged 70–74 years (18.0%). The age-standardised rate of OA hospitalisation and its proportions from all and musculoskeletal disorders hospitalisations rose, on average, by >2.0% per year during the study period. OA hospitalisation rates rose statistically significantly in all age groups except for the youngest and oldest age groups. The proportion of hip OA from all OA hospitalisations declined, while the opposite was observed for knee OA. The relative regional disparities declined in men, and the absolute regional disparities rose among women over time. The population growth and ageing could explain only about one third of the observed increases in the absolute number of OA hospitalisations between 1998–2000 and 2013–2015. Conclusions: OA hospitalisations have increased substantially, suggesting the need to improve OA prevention and primary-care management in Sweden.

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The Impact of Coronavirus Disease 2019 Epidemic on Dizziness/Vertigo Outpatients in a Neurological Clinic in China

Frontiers in Neurology ◽

10.3389/fneur.2021.663173 ◽

2021 ◽

Vol 12 ◽

Author(s):

Changqing Li ◽

Dongsheng Guo ◽

Xiangke Ma ◽

Siwei Liu ◽

Mingyong Liu ◽

...

Keyword(s):

Age Groups ◽

Early Period ◽

Absolute Number ◽

Management Policy ◽

Old Patients ◽

Common Cause ◽

Female Predominance ◽

The Absolute ◽

The Impact ◽

Paroxysmal Positional Vertigo

Objective: This study aims to investigate the impact of the coronavirus disease 2019 (COVID-19) epidemic on dizziness/vertigo outpatients in a neurological clinic in China.Methods: Against the background of the COVID-19 epidemic, the data of patients who visited the neurological clinic of Beijing Chaoyang Hospital West Branch during the pandemic (February 1–May 30, 2020) and the corresponding period in 2019 (February 1–May 30, 2019) were analyzed, and patients with dizziness/vertigo from these two periods were compared to discover their demographic features and etiologic distribution according to their age and sex.Result: The absolute number of neurological outpatients decreased from 14,670 in 2019 to 8,763 in 2020 (−40.3%), with a corresponding decline in dizziness/vertigo patients (2019: n = 856; 2020: n = 1,436, −40.4%). Dizziness/vertigo was more common in women than men in these two periods (2019: women = 63.6%; 2020: women = 63.1%, p = 0.82). The overall etiology distribution was different among all disorders between the two periods (p < 0.001). There was an increase in benign paroxysmal positional vertigo (BPPV) (2019 vs. 2020: 30.7 vs. 35%, p < 0.05) and psychogenic/persistent postural perceptual dizziness (PPPD) (2019 vs. 2020: 28.5 vs. 34.6%, p < 0.05) while a decrease in vascular vertigo during the epidemic (2019 vs. 2020: 13 vs. 9.6%, p < 0.05). During the epidemic, the top three causes of dizziness/vertigo were BPPV (35%), psychogenic/PPPD (34.6%), and vascular vertigo (9.6%). A female predominance was observed in BPPV (women = 67.7%, p < 0.05) and psychogenic/PPPD (women = 67.6%, p < 0.05). In addition, the etiology ratio of different age groups was significantly different (p < 0.001). The most common cause for young and young-old patients was BPPV, and the most common cause for middle-aged and old-old patients was psychogenic/PPPD.Conclusion: The absolute number of outpatients with dizziness/vertigo during the COVID-19 pandemic was reduced during the early period of the COVID-19 outbreak. BPPV and psychogenic/PPPD were more abundant, and vascular vertigo was less frequent. Based on those data, health-care management policy for dizziness/vertigo and mental disorder should be developed during the outbreak of COVID-19 and other infective diseases.

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P4614Predictor factors of microvascular obstruction in early presenters of ST-segment elevation myocardial infarction

European Heart Journal ◽

10.1093/eurheartj/ehz745.0997 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

A L Rivero Monteagudo ◽

B Arroyo Rivera ◽

C Garcia Talavera ◽

M Cortes Garcia ◽

J A Franco Pelaez ◽

...

Keyword(s):

Myocardial Infarction ◽

Microvascular Obstruction ◽

Cox Regression ◽

Class Iii ◽

Cox Regression Analysis ◽

Killip Class ◽

St Segment Elevation ◽

Segment Elevation Myocardial Infarction ◽

St Segment ◽

The Mean

Abstract Background Microvascular obstruction (MVO) is a phenomenon that occurs frequently even after primary coronary intervention with recanalization of the infarct-related artery (IRA) and it has been shown to increase the risk of adverse cardiovascular events in ST-segment elevation myocardial infarction (STEMI) patients. The most important clinical predictor of MVO is ischemia duration, but there is a lack of information regarding predictor factors in promptly revascularized patients. Methods From January 2007 to October 2017, 1022 patients with STEMI that underwent urgent coronary angiography were retrospectively enlisted. We included 760 patients that were revascularized in ≤6 hours from symptom onset. Clinical, echocardiographic and angiographic data were taken from hospital records. A multivariate Cox regression analysis was made to assess the relationship between MVO (defined as final TIMI <3 in IRA) and potential predictors. Results From the 760 patients included, 73.7% were male and the mean age was 64.8±14.2 years. LVEF at admission was 46.1±12% and Killip class at admission was III-IV in 12.8% of the cases. The mean time between symptom onset and wire crossing was 3.3±1.3 hours. MVO was found in 130 cases (17.2%). After the multivariate Cox regression analysis, Killip class III-IV at admission was associated with MVO (OR 2.87 [1.31–6.31]). No other clinical variables were independently associated with the occurrence of MVO. The angiographic and interventional variables with a significant association with MVO were: predilatation (OR 1.87 [1.003–3.49]), postdilatation (OR 0.49 [0.27–0.89]), stent length (OR 1.04 [1.001–1.08]), stent diameter (OR 1.89 [1.11–3.23]), thrombus burden of the culprit lesion (OR 2.69 [1.26–5.71]) and distal embolization (OR 5.52 [2.79–10.89]). Conclusions In early presenters of STEMI, angiographic and interventional variables were more important as predictors of MVO than clinical variables. Killip class III-IV at admission was a clinical predictor factor for MVO in this population. Prospective studies are needed to confirm these results.

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TERIMA-2: National Extension of Thrombolytic Treatment with Recombinant Streptokinase in Acute Myocardial Infarct in Cuba

Thrombosis and Haemostasis ◽

10.1055/s-0037-1614154 ◽

2000 ◽

Vol 84 (12) ◽

pp. 949-954 ◽

Cited By ~ 4

Author(s):

María Marrero-Miragaya ◽

Keyword(s):

Recombinant Dna ◽

Myocardial Infarct ◽

Relative Reduction ◽

Time Interval ◽

Infusion Time ◽

Acute Myocardial Infarct ◽

Major Health Problem ◽

Pump Failure ◽

Killip Class ◽

St Segment Elevation

Summary Aim: The extension of recombinant streptokinase (rSK) use in Cuba and to evaluate its effect on in-hospital mortality of patients with acute myocardial infarct (AMI). Methods: A phase IV clinical study was performed in 52 hospitals from the 14 Cuban provinces. Patients (any age) with ST segment elevation or bundle branch block were included if they came less than 12 h after the onset of AMI symptoms, without contraindications for thrombolytic therapy. They received 1.5 × 106 IU of rSK (Heberkinasa, Heberbiotec, Havana) intravenously, during one hour. Endpoints were death due to cardiac (pump failure, wall rupture, arrhythmia) or any cause and cardiovascular events at hospital release. Results: The study included 2923 patients, 22 – 98 years-old, 74.4% men, which represented 37.2% of the total AMI patients attended at the participating hospitals from November 1992 to May 1995. Aspirin was given to 92.5% and betablockers to 65.3%. AMI was confirmed in 93.5% of the patients. The mean symptoms – rSK infusion time interval was 5.25 h (22.3% of the patients treated within the first 3 h). 302 patients died, 80.1% of them due to cardiac causes, 12 attributed to rSK treatment, and 16 to non-cardiac causes. This 10.4% mortality represents a 4% absolute and a 28.3% relative reduction (179 lives saved per year) as compared to a survey made before rSK treatment was introduced. In a logistic regression analysis, mortality was favored by age, symptoms – infusion time, Killip class, and not having taken aspirin or betablockers. Feminine gender was close to the limit of significance. The more frequent adverse events were arrhythmias and hypotension during infusion. Major bleeding occurred in 27 patients (9 strokes). Conclusion: Local recombinant-DNA biotechnology can influence on a major health problem with favorable cost/ and risk/ benefit balances, not possible in a developing country with an imported drug. The further extension of this treatment in the country is feasible and recommended, monitored through an appropriate pharmacosurveillance program.

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Clinical factors associated with microvascular obstruction in early presenters of ST-segment elevation myocardial infarction

European Heart Journal ◽

10.1093/ehjci/ehaa946.1589 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

A.L Rivero Monteagudo ◽

B Arroyo Rivera ◽

C Garcia Talavera ◽

M Cortes Garcia ◽

J.A Franco Pelaez ◽

...

Keyword(s):

Microvascular Obstruction ◽

Cox Regression ◽

Class Iii ◽

Cox Regression Analysis ◽

Killip Class ◽

St Segment Elevation ◽

Segment Elevation Myocardial Infarction ◽

St Segment ◽

The Mean ◽

Predictor Factors

Abstract Background Microvascular obstruction (MVO) is a phenomenon that occurs frequently even after primary coronary intervention with recanalization of the infarct-related artery (IRA) and it has been shown to increase the risk of adverse cardiovascular events in ST-segment elevation myocardial infarction (STEMI) patients. The most important clinical predictor of MVO is ischemia duration, but there is a lack of information regarding predictor factors in promptly revascularized patients. Methods From January 2007 to October 2017, 987 patients with STEMI that underwent urgent coronary angiography were retrospectively enlisted. We included 321 patients that were revascularized in ≤3 hours from symptom onset. Clinical and angiographic data were taken from hospital records. A univariate and multivariate Cox regression analysis was made to assess the relationship between MVO (defined as final TIMI <3 in IRA) and potential predictors. Results From the 321 patients included, 76.9% were male and the mean age was 63.6±13.4 years. LVEF at admission was 46.2±12%. The mean time between symptom onset and wire crossing was 2.2±0.6 hours and MVO was found in 43 cases (13.4%). Descriptive data of predictor factors and their association with MVO are shown in Table 1. After the multivariate Cox regression analysis, smoking was a protector factor of MVO (OR 0.39 [0.16–0.96]). Age (OR 1.03 [1.01–1.06]) and Killip class III-IV at admission (OR 5.96 [2.1–16.4]) were directly associated with MVO. No other clinical variables were independently associated with the occurrence of MVO. Conclusions In very early presenters of STEMI, age and Killip class III-IV at admission were clinical predictor factors of MVO. Current smoking could carry a protector mechanism for MVO in this population, that is yet to be confirmed with prospective studies. Funding Acknowledgement Type of funding source: None

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