Clinical and Anamnestic Characteristics of Acute Coronary Syndrome after Suffering COVID-19

Cover Page


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Background. COVID-19 increases the risk of developing thromboembolic complications, including acute myocardial infarction, in the acute period of the disease. The long-term consequences of COVID-19 are poorly understood. At the same time, the available data on an increased risk of acute coronary syndrome after infectious diseases allow us to make an assumption about a similar risk in COVID-19. The aim of the study was to study the anamnestic and laboratory diagnostic data in patients with acute coronary syndrome after COVID-19. Methods. The study included 185 patients with acute coronary syndrome who were admitted to the State Clinical Hospital No. 13 in Moscow in the period from May to December 2020. 2 groups were identified: group 1 — 109 patients with ACS who had previously suffered COVID-19, group 2 — 76 patients with ACS without COVID-19 in the past. The patients were collected anamnesis, including: the fact of smoking and alcohol consumption, heredity, previous diseases, including diabetes mellitus, acute myocardial infarction, previously performed PCI. Information about the COVID-19 infection has been collected (the duration of the disease, the course of the disease). A clinical and laboratory examination was conducted, including the determination of body mass index (BMI), examination for antibodies to COVID-19, determination of the lipid profile level (total cholesterol, LDL, HDL, triglycerides), blood glucose level, C-RB. The analysis was performed on automatic biochemical analyzers Hitachi-902, 912 (Roche Diagnostics, Japan). All patients underwent coronary angiography. Results. In patients with ACS with previously transferred COVID-19, the development of the disease occurred at a younger age compared to patients without transferred COVID-19. Among the patients with COVID-19, body weight was significantly lower, there were fewer smokers, concomitant type 2 diabetes mellitus and transferred ONMC were less common. In laboratory parameters, lower triglyceride levels were observed in patients with ACS with COVID-19 compared with those of patients without COVID-19. In the laboratory parameters of blood clotting in patients with ACS with COVID-19, higher APTT, thrombin time, fibrinogen level, D-dimer were noted. The indicated laboratory parameters in the groups had statistically significant differences. In ACS patients with a previous COVID-19, compared with patients without COVID-19, the lesion of 2 or more coronary vessels was more common in the anamnesis. Conclusion. According to the results of our study, it was revealed that multivessel coronary artery damage in patients after COVID-19 in comparison with patients without COVID-19 develops significantly more often, while these patients are significantly less likely to have DM and previously suffered ONMC, the level of TG is significantly lower.

Full Text

Restricted Access

About the authors

Natalia V. Orlova

Pirogov Russian National Research Medical University

Email: vrach315@yandex.ru
ORCID iD: 0000-0002-4293-3285
SPIN-code: 8775-1299

MD, PhD, Professor

Russian Federation, 1 Ostrovityanova str., 117997, Moscow

Valerij V. Lomajchikov

Pirogov Russian National Research Medical University

Email: lomaychikov@yandex.ru

Assistant

Russian Federation, 1, Ostrovityanova str., 117997, Moscow

Tatyana I. Bonkalo

Research Institute for Healthcare Organization and Medical Management

Email: bonkalotatyanaivanovna@yandex.ru
ORCID iD: 0000-0003-0887-4995
SPIN-code: 6572-7417

MD, PhD in Psychology, Professor

Russian Federation, Moscow

Grigorij A. Chuvarayan

Pirogov Russian National Research Medical University

Email: grigoriy.chuvarayan@gmail.com
ORCID iD: 0000-0002-4503-6280

MD, PhD, Assistant Professor

Russian Federation, 1, Ostrovityanova str., 117997, Moscow

Yana G. Spiryakina

Pirogov Russian National Research Medical University

Email: janezo@yandex.ru
ORCID iD: 0000-0002-1006-4118
SPIN-code: 5620-6667

MD, PhD, Assistant Professor

Russian Federation, 1, Ostrovityanova str., 117997, Moscow

Anna P. Petrenko

Pirogov Russian National Research Medical University

Email: petrenkoAnna5@yandex.ru

Clinical Resident

Russian Federation, 1, Ostrovityanova str., 117997, Moscow

Tatyana V. Pinchuk

Pirogov Russian National Research Medical University

Author for correspondence.
Email: doktor2000@inbox.ru
ORCID iD: 0000-0002-7877-4407
SPIN-code: 1940-2017

MD, PhD, Assistant Professor

Russian Federation, 1, Ostrovityanova str., 117997, Moscow

References

  1. Patel VD, Patel KH, Lakhani DA, Desai R, Mehta D, Mody P, Pruthi S. Acute pericarditis in a patient with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection: a case report and review of the literature on SARS-CoV-2 cardiological manifestations. AME Case Rep. 2021 Jan 25;5:6. doi: 10.21037/acr-20-90. PMID: 33634246; PMCID: PMC7882268.
  2. Chen C, Zhou Y, Wang DW. SARS-CoV-2: a potential novel etiology of fulminant myocarditis. Herz. 2020 May;45(3):230-232. doi: 10.1007/s00059-020-04909-z. PMID: 32140732; PMCID: PMC7080076.
  3. Driggin E, Madhavan MV, Bikdeli B, Chuich T, Laracy J, Bondi-Zoccai G, et al. Cardiovascular considerations for patients, health care workers, and health systems during the coronavirus disease 2019 (COVID-19) pandemic. J Am Coll Cardiol. (2020) 75:2352–71. doi: 10.1016/j.jacc.2020.03.031.
  4. Guzik TJ, Mohiddin SA, Dimarco A, Patel V, Savvatis K, Marelli-Berg FM, et al. COVID-19 and the cardiovascular system: implications for risk assessment, diagnosis, and treatment options. Cardiovasc Res. (2020) 116:1666–87. doi: 10.1093/cvr/cvaa106.
  5. Musher DM, Abers MS, Corrales-Medina VF. Acute Infection and Myocardial Infarction. N Engl J Med. 2019 Jan 10;380(2):171-176. doi: 10.1056/NEJMra1808137. PMID: 30625066.
  6. Saikku P. Epidemiologic association of Chlamydia pneumoniae and atherosclerosis: The initial serologic observation and more J Infect Dis 2000 Jun;181 Suppl 3:S411-3. doi: 10.1086/315625.
  7. Prasad A, Zhu J, Halcox JP, Waclawiw MA, Epstein SE, Quyyumi AA. Predisposition to atherosclerosis by infections: role of endothelial dysfunction. Circulation. 2002 Jul 9;106(2):184-90. doi: 10.1161/01.cir.0000021125.83697.21. PMID: 12105156.
  8. Blackburn R, Zhao H, Pebody R, Hayward A, Warren-Gash C. Laboratory-Confirmed Respiratory Infections as Predictors of Hospital Admission for Myocardial Infarction and Stroke: Time-Series Analysis of English Data for 2004-2015. Clin Infect Dis. 2018 Jun 18;67(1):8-17. doi: 10.1093/cid/cix1144. PMID: 29324996; PMCID: PMC6005111.
  9. Barnes M, Heywood AE, Mahimbo A, Rahman B, Newall AT, Macintyre CR. Acute myocardial infarction and influenza: a meta-analysis of case-control studies. Heart. 2015 Nov;101(21):1738-47. doi: 10.1136/heartjnl-2015-307691. Epub 2015 Aug 26. PMID: 26310262; PMCID: PMC4680124.
  10. Guan X, Yang W, Sun X, Wang L, Ma B, Li H, Zhou J. Association of influenza virus infection and inflammatory cytokines with acute myocardial infarction. Inflamm Res. 2012 Jun;61(6):591-8. doi: 10.1007/s00011-012-0449-3. Epub 2012 Feb 29. PMID: 22373653.
  11. Clayton TC, Capps NE, Stephens NG, Wedzicha JA, Meade TW. Recent respiratory infection and the risk of myocardial infarction. Heart. 2005 Dec;91(12):1601-2. doi: 10.1136/hrt.2004.046920. PMID: 16287745; PMCID: PMC1769237.
  12. Kwong JC, Schwartz KL, Campitelli MA, Chung H, Crowcroft NS, Karnauchow T, et al. Acute Myocardial Infarction after Laboratory-Confirmed Influenza Infection. N Engl J Med. 2018 Jan 25;378(4):345-353. doi: 10.1056/NEJMoa1702090. PMID: 29365305.
  13. Caussin C, Escolano S, Mustafic H, Bataille S, Tafflet M, Chatignoux E, et al. CARDIO-ARSIF Registry Investigators. Short-term exposure to environmental parameters and onset of ST elevation myocardial infarction. The CARDIO-ARSIF registry. Int J Cardiol. 2015 Mar 15;183:17-23. doi: 10.1016/j.ijcard.2015.01.078. Epub 2015 Jan 28. PMID: 25662048.
  14. Auer J, Berent R, Weber T, Eber B. Influenza virus infection, infectious burden, and atherosclerosis. Stroke. 2002 Jun;33(6):1454-5. doi: 10.1161/01.str.0000018667.77849.95. PMID: 12052970.
  15. Madjid M, Aboshady I, Awan I, Litovsky S, Casscells SW. Influenza and cardiovascular disease: is there a causal relationship? Tex Heart Inst J. 2004;31(1):4-13. PMID: 15061620; PMCID: PMC387426.60.
  16. Liu PP, Blet A, Smyth D, Li H. The Science Underlying COVID-19: Implications for the Cardiovascular System. Circulation. 2020 Jul 7;142(1):68-78. doi: 10.1161/CIRCULATIONAHA.120.047549. Epub 2020 Apr 15. PMID: 32293910.
  17. Stefanini GG, Montorfano M, Trabattoni D, Andreini D, Ferrante G, Ancona M, et al. ST-Elevation Myocardial Infarction in Patients With COVID-19: Clinical and Angiographic Outcomes. Circulation. 2020 Jun 23;141(25):2113-2116. doi: 10.1161/CIRCULATIONAHA.120.047525. Epub 2020 Apr 30. PMID: 32352306; PMCID: PMC7302062.
  18. Long B, Brady WJ, Koyfman A, Gottlieb M. Cardiovascular complications in COVID-19. Am J Emerg Med. 2020 Jul;38(7):1504-1507. doi: 10.1016/j.ajem.2020.04.048. Epub 2020 Apr 18. PMID: 32317203; PMCID: PMC7165109.
  19. Kochi AN, Tagliari AP, Forleo GB, Fassini GM, Tondo C. Cardiac and arrhythmic complications in patients with COVID-19. J Cardiovasc Electrophysiol. 2020 May;31(5):1003-1008. doi: 10.1111/jce.14479. Epub 2020 Apr 13. PMID: 32270559; PMCID: PMC7262150.
  20. Yaghi S, Ishida K, Torres J, Mac Grory B, Raz E, Humbert K, et al. SARS-CoV-2 and Stroke in a New York Healthcare System. Stroke. 2020 Jul;51(7):2002-2011. doi: 10.1161/STROKEAHA.120.030335. Epub 2020 May 20. Erratum in: Stroke. 2020 Aug;51(8):e179. PMID: 32432996; PMCID: PMC7258764.
  21. Escalard S, Maïer B, Redjem H, Delvoye F, Hébert S, Smajda S, et al. Treatment of Acute Ischemic Stroke due to Large Vessel Occlusion With COVID-19: Experience From Paris. Stroke. 2020 Aug;51(8):2540-2543. doi: 10.1161/STROKEAHA.120.030574. Epub 2020 May 29. PMID: 32466736; PMCID: PMC7282400.
  22. Hamadeh A, Aldujeli A, Briedis K, Tecson KM, Sanz-Sánchez J, Al Dujeili M, et al. Characteristics and Outcomes in Patients Presenting With COVID-19 and ST-Segment Elevation Myocardial Infarction. Am J Cardiol. 2020 Sep 15;131:1-6. doi: 10.1016/j.amjcard.2020.06.063. Epub 2020 Jul 3. PMID: 32732010; PMCID: PMC7333635.
  23. Varga Z, Flammer AJ, Steiger P, Haberecker M, Andermatt R, Zinkernagel AS, et al. Endothelial cell infection and endotheliitis in COVID-19. Lancet. 2020 May 2;395(10234):1417-1418. doi: 10.1016/S0140-6736(20)30937-5. Epub 2020 Apr 21. PMID: 32325026; PMCID: PMC7172722.
  24. Mauriello A, Sangiorgi G, Fratoni S, Palmieri G, Bonanno E, Anemona L, et al. Diffuse and active inflammation occurs in both vulnerable and stable plaques of the entire coronary tree: a histopathologic study of patients dying of acute myocardial infarction. J Am Coll Cardiol. 2005 May 17;45(10):1585-93. doi: 10.1016/j.jacc.2005.01.054. Epub 2005 Apr 25. PMID: 15893171.
  25. Long B, Brady WJ, Koyfman A, Gottlieb M. Cardiovascular complications in COVID-19. Am J Emerg Med. 2020 Jul;38(7):1504-1507. doi: 10.1016/j.ajem.2020.04.048. Epub 2020 Apr 18. PMID: 32317203; PMCID: PMC7165109.
  26. Sandoval Y, Jaffe AS. Type 2 Myocardial Infarction: JACC Review Topic of the Week. J Am Coll Cardiol. 2019 Apr 16;73(14):1846-1860. doi: 10.1016/j.jacc.2019.02.018. PMID: 30975302
  27. Belani P, Schefflein J, Kihira S, Rigney B, Delman BN, Mahmoudi K, et al. COVID-19 Is an Independent Risk Factor for Acute Ischemic Stroke. AJNR Am J Neuroradiol. 2020 Aug;41(8):1361-1364. doi: 10.3174/ajnr.A6650. Epub 2020 Jun 25. PMID: 32586968; PMCID: PMC7658882.
  28. Xiao JY, Zhang HN, Cao L, Cong HL. [An analysis of relationship between the severity of coronary artery lesion and risk factors of cardiovascular events in Tianjin]. Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2013 Nov;25(11):650-4. Chinese. doi: 10.3760/cma.j.issn.2095-4352.2013.11.014. PMID: 24225217.
  29. Castela S, Duarte R, Reis RP, Correia MJ, Toste J, Carmelo V, Cardim N, Adão M, Correia JM. Acute coronary syndromes in smokers: clinical and angiographic characteristics. Rev Port Cardiol. 2004 May;23(5):697-705. English, Portuguese. PMID: 15279454.

Supplementary files

Supplementary Files
Action
1. Fig. 1. Damage to coronary vessels according to coronary angiography,%

Download (119KB)

Copyright (c) 2021 "Paediatrician" Publishers LLC



This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies