scholarly journals Adverse Cardiovascular Effects of Anti-COVID-19 Drugs

2021 ◽  
Vol 12 ◽  
Author(s):  
Dongling Liu ◽  
Xiang Zeng ◽  
Zufeng Ding ◽  
Fenghua Lv ◽  
Jawahar L. Mehta ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Adverse Effects ◽  
Myocardial Injury ◽  
Cardiovascular Effects ◽  
Cardiovascular Complications ◽  
Therapeutic Interventions ◽  
Risk Of Death ◽  
Cardiovascular Comorbidities ◽  
Global Pandemic ◽  
Acute Myocardial Injury

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or COVID-19 infection is the cause of the ongoing global pandemic. Mortality from COVID-19 infection is particularly high in patients with cardiovascular diseases. In addition, COVID-19 patients with preexisting cardiovascular comorbidities have a higher risk of death. Main cardiovascular complications of COVID-19 are myocardial infarction, myocarditis, acute myocardial injury, arrhythmias, heart failure, stroke, and venous thromboembolism. Therapeutic interventions in terms of drugs for COVID-19 have many cardiac adverse effects. Here, we review the relative therapeutic efficacy and adverse effects of anti-COVID-19 drugs.

scholarly journals Life-Time Risk, Screening and The Cost of Cardiovascular Comorbidities in CKD Patients

PRILOZI ◽  
2015 ◽  
Vol 36 (2) ◽  
pp. 85-90
Author(s):  
Carmine Zoccali ◽  
Samar Abd ElHafeez ◽  
Evangelia Dounousi ◽  
Rossana Anastasi ◽  
Giovanni Tripepi ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Life Time ◽  
Epidemiological Data ◽  
Cardiovascular Complications ◽  
Insurance Company ◽  
Risk Of Death ◽  
Cardiovascular Comorbidities ◽  
Large Member ◽  
The Cost ◽  
Risk Equivalent

Abstract CKD is a problem of epidemic dimension. The risk of death and cardiovascular complications in this condition is of the same order of that by myocardial infarction, which qualifies CKD as “risk equivalent”. Calculations made on the basis of the epidemiological data of the MONICA-Augsburg study and analyses of the costs of myocardial infarction in a large health insurance company in Germany show that the economic burden of cardiovascular comorbidities with CKD in this country is substantial. These estimates, which may be valid also for other large member states of the European Community, represent a call for studies looking at the cost-effectiveness of preventive interventions aimed at reducing the risk for CKD and at lowering the concerning incidence rate of death and disability due to CKD-triggered cardiovascular complications in CKD patients.

Acute versus chronic myocardial injury and long-term outcomes

Heart ◽  
2019 ◽  
Vol 105 (24) ◽  
pp. 1905-1912 ◽  
Author(s):  
Erik Kadesjö ◽  
Andreas Roos ◽  
Anwar Siddiqui ◽  
Liyew Desta ◽  
Magnus Lundbäck ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Myocardial Injury ◽  
Troponin T ◽  
Long Term Outcomes ◽  
Adjusted Risk ◽  
Risk Of Death ◽  
Acute Myocardial Injury ◽  
Similar Risk

ObjectiveThere is a paucity of data regarding prognosis in patients with acute versus chronic myocardial injury for long-term outcomes. We hypothesised that patients with chronic myocardial injury have a similar long-term prognosis as patients with acute myocardial injury.MethodsIn an observational cohort study of 22 589 patients who had high-sensitivity cardiac troponin T (hs-cTnT) measured in the emergency department during 2011–2014, we identified all patients with level >14 ng/L and categorised them as acute myocardial injury, type 1 myocardial infarction (T1MI), type 2 myocardial infarction (T2MI) or chronic myocardial injury through adjudication. We estimated adjusted HRs with 95% CIs for the primary outcome all-cause mortality and secondary outcomes MI, and heart failure in patients with acute myocardial injury, T1MI and T2MI compared with chronic myocardial injury.ResultsIn total, 3853 patients were included. During 3.9 (±2) years of follow-up, 48%, 24%, 44% and 49% of patients with acute myocardial injury, T1MI, T2MI and chronic myocardial injury died, respectively. Patients with acute myocardial injury had higher adjusted risks of death (1.21, 95% CI 1.08 to 1.36) and heart failure (1.24, 95% CI 1.07 to 1.43), but a similar risk for myocardial infarction (MI) compared with the reference group. Patients with T1MI had a lower adjusted risk of death (0.86, 95% CI 0.74 to 1.00) and higher risk of MI (2.09, 95% CI 1.62 to 2.68), but a similar risk of heart failure. Patients with T2MI had a higher adjusted risk of death (1.46, 95% CI 1.18 to 1.80) and heart failure (1.30, 95% CI 1.00 to 1.69) compared with patients with chronic myocardial injury.ConclusionsAbsolute long-term risks for death are similar, and adjusted risks are slightly higher, among patients with acute myocardial injury and T2MI, respectively, compared with chronic myocardial injury. The lowest risk of long-term mortality was found in patients with T1MI. Both acute and chronic myocardial injury are associated with very high risks of adverse outcomes.

scholarly journals Focal ST-segment elevation without coronary occlusion: myocardial infarction with no obstructive coronary atherosclerosis associated with COVID-19—a case report

2021 ◽  
Vol 5 (2) ◽  
Author(s):  
Casey Meizinger ◽  
Bruce Klugherz
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Respiratory Failure ◽  
Coronary Atherosclerosis ◽  
Myocardial Injury ◽  
Cardiovascular Complications ◽  
St Segment Elevation ◽  
St Segment ◽  
Hypoxic Respiratory Failure ◽  
Artery Disease

Abstract Background While it is understood that coronavirus disease 2019 (COVID-19) is primarily complicated by respiratory failure, more data are emerging on the cardiovascular complications of this disease. A subset of COVID-19 patients present with ST-elevations on electrocardiogram (ECG) yet normal coronary angiography, a presentation that can fit criteria for myocardial infarction with no obstructive coronary atherosclerosis (MINOCA). There is little known about non-coronary myocardial injury observed in patients with COVID-19, and we present a case that should encourage further conversation and study of this clinical challenge. Case summary An 86-year-old man presented to our institution with acute hypoxic respiratory failure and an ECG showing anteroseptal ST-segment elevation concerning for myocardial infarction. Mechanic ventilation was initiated prior to presentation, and emergent transthoracic echocardiography reported an ejection fraction of 50–55%, with no significant regional wall motion abnormalities. Next, emergent coronary angiography was performed, and no significant coronary artery disease was detected. The patient tested positive for COVID-19. Despite supportive management in the intensive care unit, the patient passed away. Discussion We present a case of COVID-19 that is likely associated with MINOCA. It is crucial to understand that in COVID-19 patients with signs of myocardial infarction, not all myocardial injury is due to obstructive coronary artery disease. In the case of COVID-19 pathophysiology, it is important to consider the cardiovascular effects of hypoxic respiratory failure, potential myocarditis, and significant systemic inflammation. Continued surveillance and research on the cardiovascular complications of COVID-19 is essential to further elucidate management and prognosis.

scholarly journals Plaque erosion causing ST-elevation myocardial infarction after consumption of cannabis and N2O in a 27-year old man: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sarah Bär ◽  
Fabien Praz ◽  
Lorenz Räber
Keyword(s):  
Myocardial Infarction ◽  
Case Report ◽  
Adverse Effects ◽  
Cardiovascular Effects ◽  
Drug Eluting Stent ◽  
Culprit Lesion ◽  
Vascular Events ◽  
The Public ◽  
Plaque Erosion ◽  
First Case

Abstract Background The recreational drugs cannabis and nitrous oxide (N2O) are known for pro-atherogenic effects and are associated with an elevated risk of myocardial infarction. These cardiovascular effects might be underestimated by the public. Culprit-lesion composition of myocardial infarctions associated with cannabis and N2O has been unknown so far. This case report aims to raise the awareness of the adverse cardiovascular effects of cannabis and N2O and reports, for the first time, optical coherence tomography (OCT) findings of the culprit lesion. Case presentation This is a case report of a 27-year old man with anterior ST-segment-elevation myocardial infarction (STEMI) after intoxication with cannabis and N2O. Coronary angiography and OCT revealed plaque erosion with subsequent subtotal thrombotic occlusion of the left anterior descending artery that was successfully treated with 1 drug-eluting stent. The patient was symptom free at 6 months follow-up and had been able to abstain from drug consumption. Conclusions This is the first case to demonstrate the association between cannabis and N2O abuse and plaque erosion on OCT in a young man with STEMI. In contrast to smoking, whose adverse effects are well-known, the cardiovascular effects of cannabis and N2O might be underestimated. These adverse effects should gain more awareness in the public to prevent early vascular events in young adults.

Cardiovascular effects of non-cardiovascular drugs

ESC CardioMed ◽  
2018 ◽  
pp. 222-226
Author(s):  
Pauline Bosco-Levy ◽  
Julien Bezin ◽  
Francesco Salvo ◽  
Nicholas Moore
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Heart Rate ◽  
Cardiovascular Diseases ◽  
Adverse Effects ◽  
Cardiovascular Effects ◽  
Mechanisms Of Action ◽  
Cardiovascular Drugs ◽  
Vascular Bed ◽  
The Moment

Many drugs that were not designed to treat cardiovascular diseases may affect the cardiovascular system, causing adverse reactions. The objective of this chapter is to review in a systematic manner these adverse effects of non-cardiovascular drugs. The heart consists of four main entities that may be affected by non-cardiovascular drugs and lead to very different types of events: (1) the conduction tissue, that governs heart rate and rhythm, associated with arrhythmia and sudden death; (2) the endocardium and valves, associated with valvular disease and endocardial fibrosis; (3) the myocardium, which can directly or indirectly lead to heart failure; and (4) the coronary arteries, and in general the vascular bed, with myocardial ischaemia and infarction as main adverse events. These different elements may be affected by different drugs with different mechanisms of action, though some drugs may affect several components (e.g. myocardial infarction may result in heart failure). The objective of this chapter is not to provide exhaustive listings of all drugs ever associated with any of these events, which can be found online and will be obsolete the moment they are published, but an understanding of the typology of these events and their mechanism.

scholarly journals Saudi Heart Rhythm Society Task Force on Management of Potential Arrhythmogenicity Associated with Pharmacotherapy for COVID-19

2020 ◽  
Vol 40 (5) ◽  
pp. 365-372
Author(s):  
Naeem A. AlShoaibi ◽  
Khadijah Maghrabi ◽  
Haitham Alanazi ◽  
Mousa Al Harbi ◽  
Saleh Alghamdi
Keyword(s):  
Ventricular Arrhythmias ◽  
Myocardial Injury ◽  
Task Force ◽  
Heart Rhythm ◽  
Cardiovascular Complications ◽  
Qt Prolongation ◽  
Drug Induced ◽  
Global Pandemic ◽  
Risk Patients ◽  
Antiviral Medications

ABSTRACT Evidence of cardiovascular complications associated with the COVID-19 global pandemic continues to evolve. These include direct and indirect myocardial injury with subsequent acute myocardial ischemia, and cardiac arrhythmia. Some results from a limited number of trials of antiviral medications, along with chloroquine/hydroxychloroquine and azithromycin, have been beneficial. However, these pharmacotherapies may cause drug-induced QT prolongation leading to ventricular arrhythmias and sudden cardiac death. Mitigation of the potential risk in these susceptible patients may prove exceptionally challenging. The Saudi Heart Rhythm Society established a task force to perform a review of this subject based on has recently published reports, and studies and recommendations from major medical organizations. The objective of this review is to identify high-risk patients, and to set clear guidelines for management of patients receiving these pharmacotherapies.

scholarly journals Acute myocardial damage in new coronavirus infection (COVID-19)

2021 ◽  
Vol 20 (5) ◽  
pp. 98-104
Author(s):  
N. V. Izmozherova ◽  
A. A. Popov ◽  
A. I. Tsvetkov ◽  
M. A. Shambatov ◽  
I. P. Antropova ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Medical Care ◽  
Myocardial Injury ◽  
Troponin I ◽  
Myocardial Damage ◽  
True Incidence ◽  
Wide Range ◽  
Acute Myocardial Injury ◽  
Coronavirus Infection

Introduction. Acute respiratory distress syndrome (ARDS) and cardiovascular events, acute myocardial injury being the most frequent of the latter, are among the leading causes of death in COVID-19 patients. The lack of consensus on acute myocardial injury pathogenesis mechanisms, the patients management, treatment an rehabilitation logistics, the anticoagulant treatment in identified SARS-CoV-2 or suspected COVID-19 patients setting indicates the need to assess, analyze and summarize the available data on the issue.Materials and methods. Scientific publications search was carried out in PubMed, Google Scholar databases for the period from December 2019 to September 2021.Results and Discussion. Cardiospecific troponin I increase beyond reference limits is reported to occur in at least every tenth patient with identified SARS-CoV-2, the elevated troponin detection rate increasing among persons with moderate to severe course of the infection. The mechanisms of acute myocardial injury in patients with COVID-19 are poorly understood. By September 2021, there are several pathogenesis theories. A high frequency viral myocarditis direct cardiomyocytes damage is explained by the high SARS-CoV-2 affinity to ACE2 expressed in the myocardium. The cytokine storm related myocardial damage is reported a multiple organ failure consequence. Coagulopathy may also trigger myocardial microvessels damage. Up to every third death of SARS-CoV-2 infected persons is related to the acute myocardial injury. At the same time, due to the high incidence of the acute myocardial injury, it is rather difficult to assess the true incidence of acute myocardial infarction in patients with COVID-19. In the pandemic setting, the waiting time for medical care increases, the population, trying to reduce social contacts, is less likely to seek medical help. In this regard, in order to provide effective medical care to patients with acute myocardial infarction, it is necessary to develop algorithms for providing care adapted to the current epidemiological situation.Conclusion. The treatment of patients with probable development of acute myocardial damage against the background of new coronavirus infection should be performed in accordance with the current clinical guidelines. Anticoagulant therapy should be administered in a prophylactic dose under control of hemostasis parameters and a wide range of biochemical parameters.

Myocardial Perfusion Studies - Direct Imaging of Acute Myocardial Injury with 99mTc-Pyrophosphate

1978 ◽  
Vol 17 (04) ◽  
pp. 157-160
Author(s):  
J. W. Keyes
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Myocardial Perfusion ◽  
Myocardial Injury ◽  
Myocardial Tissue ◽  
Direct Imaging ◽  
Perfusion Studies ◽  
Acute Myocardial Injury ◽  
Myocardial Perfusion Studies

Imaging of acute myocardial injury is possible with a large number of agents. All of these agents share similar patterns of uptake in acutely injured myocardial tissue. The technique appears to be a reliable way of ruling in or out the diagnosis of acute myocardial infarction.

scholarly journals Copeptin Testing in Acute Myocardial Infarction: Ready for Routine Use?

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Sebastian Johannes Reinstadler ◽  
Gert Klug ◽  
Hans-Josef Feistritzer ◽  
Bernhard Metzler ◽  
Johannes Mair
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Risk Stratification ◽  
Myocardial Injury ◽  
Early Stage ◽  
Additional Information ◽  
Acute Myocardial Injury ◽  
Coronary Syndromes ◽  
Suspected Acute Myocardial Infarction ◽  
Cardiac Troponins

Suspected acute myocardial infarction is one of the leading causes of admission to emergency departments. In the last decade, biomarkers revolutionized the management of patients with suspected acute coronary syndromes. Besides their pivotal assistance in timely diagnosis, biomarkers provide additional information for risk stratification. Cardiac troponins I and T are the most sensitive and specific markers of acute myocardial injury. Nonetheless, in order to overcome the remaining limitations of these markers, novel candidate biomarkers sensitive to early stage of disease are being extensively investigated. Among them, copeptin, a stable peptide derived from the precursor of vasopressin, emerged as a promising biomarker for the evaluation of suspected acute myocardial infarction. In this review, we summarize the currently available evidence for the usefulness of copeptin in the diagnosis and risk stratification of patients with suspected acute myocardial infarction in comparison with routine biomarkers.

scholarly journals Findings on the relationship between cardiovascular disease and coronavirus disease 2019: a systematic review

2020 ◽  
Author(s):  
Yuri Henrique da Silva1 ◽  
José Gildo de Moura Monteiro Júnior ◽  
Rosângela Ferreira Frade de Araújo
Keyword(s):  
Systematic Review ◽  
Cardiovascular Disease ◽  
Cardiac Injury ◽  
The Elderly ◽  
Cardiovascular Complications ◽  
Cardiac Insufficiency ◽  
Risk Of Death ◽  
Coronary Syndrome ◽  
Cardiovascular Comorbidities ◽  
Number Of Patients

Abstract Coronavirus disease 2019 (COVID-19) presents as the main cause of death, respiratory and heart failures, especially in the elderly, immunosuppressed, and those with cardiovascular comorbidities. Therefore, a better understanding of these findings is needed. A systematic review was carried out looking for articles published between December 2019 and May 2020 on the MEDLINE / PubMed search platform using the following descriptors: ((((((((("cardiovascular disease") OR ("acute myocardial infarction")) OR ("coronary artery disease")) OR ("acute coronary syndrome")) OR ("atherosclerosis")) OR ("cardiac insufficiency")) OR ("pericarditis")) OR ("myocarditis")) AND ("COVID-19")) OR ("SARS-CoV-2")and considering inclusion and exclusion criteria.40% of patients infected with SARS-CoV-2 had hypertension or other cardiovascular comorbidities, while 27% presented cardiovascular complications, mainly acute cardiac injury, arrhythmia and heart failure. The hypotheses of involvement of an intense inflammatory response, decreased immunity and greater expression of ACE2 in the heart, associated with more severe heart conditions, were discussed in this study. The increase in cardiac and inflammatory markers was associated with worse clinical outcomes and risk of death, confirming the need to evaluate them since admission to the hospital. The 10 articles analyzed presented as a limitation the small number of patients inserted, to the detriment of the pandemic state. We warned about the need for better clinical management of patients with cardiovascular comorbidities, and the importance of including this group among the first to be immunized, aiming at reducing the number of fatal cases due to infection. Studies with greater coverage are needed for a better comprehension of the topics discussed here.

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