PDF(Pubmed)
Abstract：
BACKGROUND: Despite millions of COVID-19 cases in the United States, it remains unknown whether a history of COVID-19 infection impacts the safety of pharmacologic myocardial perfusion imaging stress testing (pharmacologic MPI).
OBJECTIVE: The aim of this study was to assess if a prior COVID-19 infection was associated with a higher risk of complications during and following pharmacologic MPI testing.
METHODS: This retrospective cohort analysis included 179 803 adults (≥18 years) from the PharMetrics® Plus claims database who underwent pharmacologic MPI between March 1, 2020 and February 28, 2021. Patients with a history of COVID-19 infection (COVID-19 group) were compared with propensity-score matched no-COVID-19 history group for reversal agent use, 30-day resource use, and post-MPI cardiac events/procedures.
RESULTS: The most commonly used stress agent was regadenoson (91.7%). The COVID-19 group (n = 6372; 3.5%) had slightly higher: reversal agent use (difference 1.13% [95% confidence interval [CI]: 0.33, 1.92]), all-cause costs (difference USD $128 [95% CI: $73-$181]), and office visits (81.5% vs. 77.0%) than the no-COVID-19 group. Prior COVID-19 infection did not appear to impact subsequent cardiac events/procedures.
CONCLUSIONS: COVID-19 history was associated with slightly higher reversal agent use, all-cause costs, and office visits after pharmacologic MPI; however, the differences were not clinically meaningful. Concerns for use of stress agents in patients with prior COVID-19 do not appear to be warranted.
OBJECTIVE: The aim of this study was to assess if a prior COVID-19 infection was associated with a higher risk of complications during and following pharmacologic MPI testing.
METHODS: This retrospective cohort analysis included 179 803 adults (≥18 years) from the PharMetrics® Plus claims database who underwent pharmacologic MPI between March 1, 2020 and February 28, 2021. Patients with a history of COVID-19 infection (COVID-19 group) were compared with propensity-score matched no-COVID-19 history group for reversal agent use, 30-day resource use, and post-MPI cardiac events/procedures.
RESULTS: The most commonly used stress agent was regadenoson (91.7%). The COVID-19 group (n = 6372; 3.5%) had slightly higher: reversal agent use (difference 1.13% [95% confidence interval [CI]: 0.33, 1.92]), all-cause costs (difference USD $128 [95% CI: $73-$181]), and office visits (81.5% vs. 77.0%) than the no-COVID-19 group. Prior COVID-19 infection did not appear to impact subsequent cardiac events/procedures.
CONCLUSIONS: COVID-19 history was associated with slightly higher reversal agent use, all-cause costs, and office visits after pharmacologic MPI; however, the differences were not clinically meaningful. Concerns for use of stress agents in patients with prior COVID-19 do not appear to be warranted.
摘要：
背景：尽管美国有数百万例COVID-19病例，COVID-19感染史是否影响药理学心肌灌注显像负荷试验(药理学MPI)的安全性尚不清楚.
目的：这项研究的目的是评估在药物MPI检测期间和之后，先前的COVID-19感染是否与更高的并发症风险相关。
方法：这项回顾性队列分析包括来自PharMetrics®Plus索赔数据库的179803名成年人（≥18岁），他们在2020年3月1日至2021年2月28日期间接受了药物MPI。将有COVID-19感染史的患者（COVID-19组）与无COVID-19病史组的逆转剂使用倾向评分进行比较，30天资源使用，和MPI后心脏事件/手术。
结果：最常用的应激剂是regadenoson（91.7％）。COVID-19组（n=6372；3.5％）稍高：逆转剂使用（差异1.13％[95％置信区间[CI]：0.33，1.92]），所有费用(差额128美元[95%CI：73-181美元])，和办公室访问(81.5%与77.0%）比无COVID-19组。先前的COVID-19感染似乎没有影响随后的心脏事件/手术。
结论：COVID-19病史与逆转剂使用率略高相关，所有原因的成本，和药物MPI后的办公室访问；然而，差异无临床意义.似乎没有理由担心在先前患有COVID-19的患者中使用应激剂。
目的：这项研究的目的是评估在药物MPI检测期间和之后，先前的COVID-19感染是否与更高的并发症风险相关。
方法：这项回顾性队列分析包括来自PharMetrics®Plus索赔数据库的179803名成年人（≥18岁），他们在2020年3月1日至2021年2月28日期间接受了药物MPI。将有COVID-19感染史的患者（COVID-19组）与无COVID-19病史组的逆转剂使用倾向评分进行比较，30天资源使用，和MPI后心脏事件/手术。
结果：最常用的应激剂是regadenoson（91.7％）。COVID-19组（n=6372；3.5％）稍高：逆转剂使用（差异1.13％[95％置信区间[CI]：0.33，1.92]），所有费用(差额128美元[95%CI：73-181美元])，和办公室访问(81.5%与77.0%）比无COVID-19组。先前的COVID-19感染似乎没有影响随后的心脏事件/手术。
结论：COVID-19病史与逆转剂使用率略高相关，所有原因的成本，和药物MPI后的办公室访问；然而，差异无临床意义.似乎没有理由担心在先前患有COVID-19的患者中使用应激剂。
