The aim of this observational study was to describe the characteristics and outcomes of coronavirus disease 2019 (COVID-19)-positive patients with ST-segment elevation myocardial infarction (STEMI), with a special focus on factors associated with a high risk of coronary thrombosis and in-hospital mortality. Comparing the two groups of patients with STEMI separated according to the presence of SARS-CoV-2 infections, it was observed that COVID-19 patients were more likely to present with dyspnea (82.43% vs. 61.41%, p = 0.048) and cardiogenic shock (10.52% vs. 5.40%, p = 0.012). A longer total ischemia time was observed in COVID-19 patients, and they were twice as likely to undergo coronary angiography more than 12 hours after the onset of symptoms (19.29% vs. 10.13%, p = 0.024). In 10 of 57 COVID-19-positive patients, a primary PCI was not necessary, and only thromboaspiration was performed (17.54% vs. 2.70%, p < 0.001). Platelet level was inversely correlated (r = −0.512, p = 0.025) with a higher risk of coronary thrombosis without an atherosclerotic lesion. Using a cut-off value of 740 ng/ml, D-dimers predicted a higher risk of coronary thrombosis, with a sensitivity of 80% and a specificity of 66% (ROC area under the curve: 0.826, 95% CI: 0.716–0.935, p = 0.001). These are novel findings that raise the question of whether more aggressive antithrombotic therapy is necessary for selected COVID-19 and STEMI patients.

(1) Background: The heart-type fatty acid-binding protein (H-FABP) is a specific myocardial biomarker and high levels indicate ischemia regardless of patient-reported symptoms. Concurrently, major adverse cardiovascular events and surgery such as coronary artery by-pass grafting (CABG) cause substantial psycho-emotional distress e.g., depression and anxiety. Comprehensive cardiac rehabilitation is, therefore, essential to both physical and psychological recovery. (2) Methods: This is a unicentric, prospective study on 120 consecutive post-CABG patients undergoing a 6-month cardiac rehabilitation program based on physical exercise, Mediterranean diet principles, and Q10 coenzyme antioxidant supplements. H-FABP levels, depression, and anxiety scores (Hamilton HAM-D and HAM-A scales) were monitored after surgery and at 6 months. (3) Results: Mean H-FABP dropped from 60.56 to 4.81. Physical ability increased from 1–2 to 4–5 METS. Mean depression and anxiety improved from 15.88 to 6.96 and from 25.13 to 15.68, respectively. Median scores went down 50% for depression and 9% for anxiety. Explored associations between H-FABP and psycho-emotional status were statistically insignificant. (4) Conclusions: patients adhered to the program and improved significantly in all studied aspects. Clinical significance is discussed in the context of countries like Romania, where such programs are limited by systemic and financial constraints. Further research directions are identified.

Guidelines for primary prevention suggested using any risk score, among those QRISK2, identifying the high-risk populations. The purpose of this study was to determine whether the QRISK2 Score would register changes in patients with coronary artery disease demanding acute or postponed CABG intervention. The QRISK2 Score was performed the day of admission after the clinical examination and blood test results, and immediately after CABG surgery (in the first week post-CABG, in an interval of 24 hours to 7 days) having another blood test evaluation. The 120 patients admitted in the Clinic of Cardiovascular Surgery of the Institute of Cardiovascular Disease met the inclusion criteria: CABG patients (less than 1 week), aged 40-85 years old, BMI ] 25 kg/m�, and mixed dyslipidemia. In both phases, for every patient, it was performed a clinical examination, a set of hematological, biochemical, lipid, coagulation and inflammatory profile, and ECG and echocardiography. Our research on hospitalized patients undergoing CABG, by comparing the Phase I and Phase III results, revealed that the median 10-year QRISK2 cardiovascular risk score was approximately 47.88 % lower (p=0.000) in the first week after cardiac surgery. QRISK2 score gives a more appropriate risk estimation based on the social component, thus identifying high risk patients associating social deprivation. Comparative to Framingham risk score, QRISK2 score, by including additional variables, proves the efficacy of lifestyle changes and management decisions, and sustaines the treatment directed towards modifying variables or risk factors.

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Cardiovascular disease is one of the leading causes of morbid-mortality, although better outcomes and lower mortality of age-adjusted coronary artery disease were registered since 1980s, especially in high-income populations, sustaining the cost effective of cardiac prevention methods. The aim of this prospective study was to evaluate the role of cardiac rehabilitation in improving psycho-emotional risk scores: the Hamilton Depression (HAM-D) and Anxiety Rating Scale (HAM-A) in coronary artery bypass grafting (CABG) patients, in less than one week after cardiovascular surgery and in 6 months follow-up after the engagement in the cardiac recovery program. Methods – During 01.05.2015 – 01.03.2017, CABG was performed in 100 patients, aged 40-80 years old, who followed rehabilitation in the Cardiovascular Rehabilitation Clinic. The mean age of the patients under study was 65.70 ± 9.91 years old. Results – In the fi rst phase of the cardiovascular rehabilitation program, the mean values were: 16 points for HAM-D, and 25 points on HAM-A scale. By comparing the Phase I and Phase III results, the median HAM-D score improved more than 50%, and HAM-A about 36% (p<0.05). Conclusion – The study highlighted the role of early rehabilitation after CABG surgery and the HAM-D and HAM-A scores improvement, emphasizing the importance of including psycho-emotional status assessment in the management of the patient who benefi ted from cardiac surgery. Apart from clinical data and the cardiovascular risk scores, the psycho-emotional risk stratification can provide important information regarding outcomes and prognosis.