Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 17 3 2022 07 28 103 111 Ata Firouzi Cardiovascular intervention research center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran. Zahra Hosseini Cardiovascular intervention research center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran. Zeinab Norouzi Cardiovascular intervention research center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran. Zohre Hosseini Cardiovascular intervention research center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran. Afshin Amirpour Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran. Hamed Talakoob Cardiovascular Research Center, Alborz University of Medical Sciences, Karaj, Iran. Arash Amin Lorestan Heart Center (Madani Hospital), Lorestan University of Medical Sciences, Khorram Abad, Lorestan, Iran. Abbas Soleimani Sina Hospital, Tehran University of Medical Sciences (TUMS), Thran, Iran. Nasrolah Moradifar Lorestan Heart Center (Madani Hospital), Lorestan University of Medical Sciences, Khorram Abad, Lorestan, Iran. Shahrokh Karbalai Sina Hospital, Tehran University of Medical Sciences (TUMS), Thran, Iran. Mohammadhosseini Mozafarybazargani Cardiovascular Research Center, Alborz University of Medical Sciences, Karaj, Iran. Hamidreza Hekmat Ziaeian Hospital, International Campus, Tehran University of Medical Sciences, Tehran, Iran. Majid Maleki Cardiovascular intervention research center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran. Parham Sadeghipour Cardiovascular intervention research center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran. Seyedeh Mahnaz Mirbod Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran. Mina Ghorbanpoor Kohnaki cardiovascular intervention research center, rajaie cardiovascular medical and research center Hooman Bakhshandeh Cardiovascular intervention research center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran. Masoomeh KalaeiNia Cardiovascular intervention research center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran. Fatemeh Sadat Habibizade Cardiovascular intervention research center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran. Sara Iraninejad Cardiovascular intervention research center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran. Mohammadreza Baay Cardiovascular intervention research center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran. Ehsan Khalilipur Cardiovascular intervention research center, Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran. 2021 12 02 2022 08 24 Background There are limited data about the clinical outcomes of patients with coronavirus disease 2019 (COVID-19) who present with ST-Segment-Elevation Myocardial Infarction (STEMI). Objectives The aim of this multicenter study is to compare baseline clinical and procedural data between the case group (STEMI patients with COVID-19) and the control group (STEMI patients before the COVID-19 pandemic) and to determine in-hospital infarct-related artery thrombus grades; major adverse cardio-cerebrovascular events (MACCE), defined as a composite of deaths from any cause (cardiovascular and non-cardiovascular), nonfatal strokes, and stent thrombosis. Results There were no significant differences between two groups regarding baseline characteristics. Primary PCI was performed in 81% of the case group and 97% of the control group (P=0.043), and primary CABG was performed in 7% of the case group and 1.4% of the control group (P=0.04). The number of successful PCI procedures (final TIMI flow grade III) was significantly lower in the case group (66.5% vs 93%; P=0.0). The baseline thrombus grade before wire crossing was not statistically significantly different between the 2 groups. The summation of thrombus grades IV and V was 75% in the case group and 82% in the control group (P=0.43). The rate of MACCE was 17% and 2.1% in the case and control groups, correspondingly (P=0.002). Conclusions In our study, the thrombus grade had no significant differences between the case group and the control group; however, the in-hospital rates of the no-reflow phenomenon, periprocedural MI, mechanical complications, and MACCE were statistically significantly higher in the case group. https://rhythm.tums.ac.ir/index.php/jthc/article/view/1564 https://rhythm.tums.ac.ir/index.php/jthc/article/download/1564/1013