Acute coronary syndrome in COVID-19 patients

Acute coronary syndrome (ACS) is caused by an acute mismatch between myocardial oxygen demand and its supply. This mechanism is largely associated with the progression of coronary atherosclerosis in combination with an inflammatory response, hypoxemia, and blood procoagulation. Patients with the coronavirus disease 2019 (COVID-19), aggravated by cardiovascular diseases and comorbidities, are at high risk of ACS.Aim. To analyze the publications, which reflects the development of ACS in patients with COVID-19, its pathogenesis, and clinical course. Material and methods. Literature data were searched using Google Scholar, PubMed, ScienceDirect, and Cyberleninka services. The analysis included data from clinical guidelines on COVID-19, data from clinical studies, reports, and systematic reviews.Results. This literature review summarizes and systematizes the data presented in modern publications, highlights the aspects of the clinical course and pathogenetic mechanisms underlying ACS in patients with COVID-19.Conclusion. The pathogenesis of COVID-19 is inextricably associated with the widespread cytopathic effect of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), uncontrolled immune response that causes systemic inflammation, as well as the coagulation system activation. In patients with COVID-19, along with the atherosclerosis, these mechanisms significantly increase the risk of ACS and can worsen its in-hospital course.

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Impact of Morning Onset on the Incidence of Recurrent Acute Coronary Syndrome and Progression of Coronary Atherosclerosis in Acute Myocardial Infarction

Circulation Journal ◽

10.1253/circj.cj-16-0817 ◽

2017 ◽

Vol 81 (3) ◽

pp. 361-367 ◽

Cited By ~ 8

Author(s):

Hiroshi Nakashima ◽

Yuka Mashimo ◽

Masaya Kurobe ◽

Shigenori Muto ◽

Shinnosuke Furudono ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Acute Coronary Syndrome ◽

Coronary Atherosclerosis ◽

Coronary Syndrome

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Acute Effects of Statin Therapy on Coronary Atherosclerosis Following an Acute Coronary Syndrome

The American Journal of Cardiology ◽

10.1016/j.amjcard.2009.05.009 ◽

2009 ◽

Vol 104 (6) ◽

pp. 750-757 ◽

Cited By ~ 18

Author(s):

Josep Rodés-Cabau ◽

Jean-Claude Tardif ◽

Mariève Cossette ◽

Olivier F. Bertrand ◽

Reda Ibrahim ◽

...

Keyword(s):

Acute Coronary Syndrome ◽

Statin Therapy ◽

Coronary Atherosclerosis ◽

Acute Effects ◽

Coronary Syndrome

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Uric acid levels are associated with endothelial dysfunction and severity of coronary atherosclerosis during a first episode of acute coronary syndrome

Purinergic Signalling ◽

10.1007/s11302-018-9604-9 ◽

2018 ◽

Vol 14 (2) ◽

pp. 191-199 ◽

Cited By ~ 10

Author(s):

Mélanie Gaubert ◽

Marion Marlinge ◽

Marine Alessandrini ◽

Marc Laine ◽

Laurent Bonello ◽

...

Keyword(s):

Acute Coronary Syndrome ◽

Uric Acid ◽

Endothelial Dysfunction ◽

Coronary Atherosclerosis ◽

First Episode ◽

Coronary Syndrome

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Association of Prediabetes With Higher Coronary Atherosclerotic Burden Among Patients With First Diagnosed Acute Coronary Syndrome

Angiology ◽

10.1177/0003319718772420 ◽

2018 ◽

Vol 70 (2) ◽

pp. 174-180 ◽

Cited By ~ 15

Author(s):

Burak Açar ◽

Ozcan Ozeke ◽

Mustafa Karakurt ◽

Yasin Ozen ◽

Mustafa Bilal Özbay ◽

...

Keyword(s):

Acute Coronary Syndrome ◽

Coronary Angiography ◽

Coronary Atherosclerosis ◽

Scoring Systems ◽

Diabetic Patients ◽

Coronary Syndrome ◽

Atherosclerotic Burden ◽

First Occurrence ◽

And Control ◽

The Impact

Diabetes mellitus (DM) is associated with more extensive coronary atherosclerosis and more vulnerable plaque phenotypes. However, DM should not be considered a homogeneous and purely binary entity in terms of risk assessment. We evaluated the impact of prediabetic status on coronary atherosclerosis burden in patients with first-time acute coronary syndrome (ACS) who underwent urgent coronary angiography. The patients were divided into DM, prediabetes, and control groups. The 3-vessel disease (TVD) rates and SYNTAX and Gensini scoring systems for defining atherosclerotic burden were compared. The study was conducted in 469 consecutive patients admitted with a diagnosis of ACS. Of these, 250 patients were admitted at the first occurrence of ACS undergoing diagnostic coronary angiography. SYNTAX and Gensini scores and TVD rates were higher in prediabetic patients than in nondiabetic patients ( P = .004, P = .008, and P = .014, respectively), but similar in prediabetic and diabetic patients ( P = .912, P = .773, and P = 1.000, respectively). Coronary atherosclerosis burden is more advanced in prediabetic patients than in nondiabetic patients and is comparable between prediabetic and diabetic patients at first presentation of ACS. Cardiologists should not miss the opportunity to diagnose prediabetes and DM when patients present with an ACS.

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Correlation between Serum High Sensitivity C-reactive Protein Level and Severity of Coronary Atherosclerosis Assessed by Angiographic Gensini Score in Patients with Acute Coronary Syndrome

Journal of Cardiovascular Medicine and Surgery ◽

10.21088/jcms.2454.7123.4218.5 ◽

2018 ◽

Vol 4 (2) ◽

pp. 100-107

Author(s):

Mayank Jain ◽

◽

Priyanka Kiyawat ◽

Surbhi Kiyawat ◽

◽

...

Keyword(s):

Acute Coronary Syndrome ◽

Protein Level ◽

Coronary Atherosclerosis ◽

High Sensitivity ◽

Gensini Score ◽

C Reactive Protein ◽

Reactive Protein ◽

Coronary Syndrome

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The Impact of Chronic Repetitive Leg Ischemia on Left Ventricular Function and Severity of Coronary Atherosclerosis in Patients with Acute Coronary Syndrome

Medical Principles and Practice ◽

10.1159/000481866 ◽

2017 ◽

Vol 26 (5) ◽

pp. 447-450

Author(s):

Mutlu Gungor ◽

Erkan Yildirim

Keyword(s):

Acute Coronary Syndrome ◽

Left Ventricular Function ◽

Ventricular Function ◽

Coronary Atherosclerosis ◽

Left Ventricular ◽

Coronary Syndrome ◽

The Impact ◽

Leg Ischemia

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Acute coronary syndrome without ST segment elevation: possibilities for predicting the clinical course at the posthospital (6 and 12 months) stage

Clinical Medicine (Russian Journal) ◽

10.18821/0023-2149-2016-94-3-205-210 ◽

2016 ◽

Vol 94 (3) ◽

pp. 205-210

Author(s):

Zinaida D. Mikhailova ◽

M. A. Shalenkova ◽

P. F. Klimkin

Keyword(s):

Acute Coronary Syndrome ◽

Clinical Course ◽

Regression Equations ◽

St Segment Elevation ◽

Coronary Syndrome ◽

Logistic Analysis ◽

St Segment ◽

Increased Risk ◽

Hospitalization Period ◽

Sodium And Potassium

Aim. To measure blood IL-6, IL-10, creatinine levels, calcium, sodium and potassium in blood and saliva, melatonin in urine of patients with acute coronary syndrome without ST segment elevation for the prediction of the clinical course at the posthospital stage. Material and methods. The study included 93patients with complicated (n=46) and uncomplicated (n=47) coronary syndrome without ST segment elevation. Blood IL-6, IL-10, creatinine levels, calcium, sodium and potassium in blood and saliva, melatonin in urine were determined on days 1-3 after hospitalization. 6-hydroxymelatonin was measured by HPLC in urine collected between 23 p.m. and 8 a.m., melatonin i in urine collected between 8 a.m. and 23 p.m. Results. Complicated coronary syndrome was associated with increased levels of melatonin (night), blood IL-10 and Na, salivary Na and Ca while the uncomplicated condition with increased blood melatonin (daytime), IL-6, creatinine, Ca, Na, K, and salivary K. 90 patients were followed up within 12 months after discharge. End-points developed in 36 (40%) of Original investigations them. Logistic analysis yielded variables and 2 logistic regression equations The data on night melatonin +5 and +4 were included in ROC analysis. The night melatonin +5 values over 0.7453 were associated with increased risk of complications in the post-hospital period (6 months) and values of0.7453 or lower with the enhanced probability of uncomplicated clinical course. Prognostic sensitivity was estimated at 90%, specificity at -54.39%. The night melatonin +4 values over 0.2903 were associated with increased risk of complications in the post-hospital period (12 months) and values of 0.2903 or lower with the enhanced probability of uncomplicated clinical course. Prognostic sensitivity was estimated at 77.8%, specificity at -59.26%. Conclusion. The night melatonin +5 and +4 models can be used to predict the clinical course of acute coronary syndrome during 6 and 12 months of the post-hospitalization period.

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Effects of Ezetimibe-Statin Combination Therapy on Coronary Atherosclerosis in Acute Coronary Syndrome

Circulation Journal ◽

10.1253/circj.cj-17-0598 ◽

2018 ◽

Vol 82 (3) ◽

pp. 757-766 ◽

Cited By ~ 8

Author(s):

Kiyoshi Hibi ◽

Shinjo Sonoda ◽

Masanori Kawasaki ◽

Yutaka Otsuji ◽

Toyoaki Murohara ◽

...

Keyword(s):

Acute Coronary Syndrome ◽

Combination Therapy ◽

Coronary Atherosclerosis ◽

Coronary Syndrome

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Long-term results of different approaches to revascularization in non-ST-segment elevation acute coronary syndrome and multiple coronary atherosclerosis

Terapevticheskii arkhiv ◽

10.17116/terarkh201789429-34 ◽

2017 ◽

Vol 89 (4) ◽

pp. 29-34 ◽

Cited By ~ 1

Author(s):

V I Ganyukov ◽

R S Tarasov ◽

Yu N Neverova ◽

N A Kochergin ◽

O L Barbarash ◽

...

Keyword(s):

Acute Coronary Syndrome ◽

Coronary Artery ◽

Medical Treatment ◽

Coronary Atherosclerosis ◽

Long Term Results ◽

St Segment Elevation ◽

Coronary Syndrome ◽

St Segment

Aim. To assess the long-term results of different approaches to treating patients with non-ST-segment elevation acute coronary syndrome (NSTE ACS) and multivessel coronary artery disease (MVCAD). Subjects and methods. A total of 150 patients with NSTE ACS, in whom coronary angiography revealed MVCAD, were examined. The patients were divided into 3 groups according to the selected treatment policy: 1) percutaneous coronary intervention (PCI) (n=91 (60.6%)); 2) coronary artery bypass grafting (CABG) (n=40 (26.6%)); and 3) only medical treatment (n=9 (6%)). The mean follow-up was 27.6±3.5 months. Results. The medical treatment policy in this patient sample demonstrates the worst results, with the majority of cardiovascular events developing in the hospital period. PCI in patients with NSTE ACS and multiple coronary atherosclerosis has a number of objective limitations in this patient sample, leading to suboptimal treatment outcomes Conclusion. The use of CABG or PCI as a myocardial revascularization technique in patients with NSTE ACS and MVCAD is characterized by a comparable satisfactory survival in the hospital and long-term follow-up periods. 12% of patients do not receive revascularization due to the extremely high risk from any of coronary blood restoring methods, which results in very many deaths largely occurring during the hospital period.

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