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.
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。