Single-center register of myocardial revascularization in patients with coronary artery disease and acute coronary syndrome in the context of COVID-19 pandemic

Abstract

Aim. To assess the short- and long-term outcomes of myocardial re- vascularization (MR) in patients with coronary artery disease (CAD) and acute coronary syndrome (ACS) in the context of coronavirus disease 2019 (COVID-19) pandemic.Material and methods. In the period from April to August 2020, 550 patients with CAD and ACS were included in the register. Emergency percutaneous transluminal coronary angioplasty (n=499) and on-pump coronary artery bypass grafting (CABG) (n=51) were performed. The follow-up period lasted 6 months. The pattern of complications after MR and effects of COVID-19 were analyzed.Results. The studied cohort is represented by patients with CAD >65 years old. ST segment elevation ACS was detected in 23%, acute myocardial infarction — in 59,1%, in other cases — unstable angina. During hospitalization after MR, atrial fibrillation prevailed among cardiovascular complications (4,7%). During this period, 29 (5,3%) patients was diagnosed with COVID-19. In the short-term period after MR, 3 (0,5%) people died due to COVID-19 complications-. In the long-term period after MR, 4 (0,7%) cases of non-fatal stroke were registered, while repeated MR — in 7,1%. The all-cause mortality rate was 1,3% (n=7), of which 57,1% of patients died due to COVID-19 complications. In the subgroup of patients who underwent CABG, the greatest number of in-hospital complications was noted, where exudative pleurisy, atrial fibrillation and anemia prevailed. Of the patients with COVID-19, pneumonia in the short-and long-term posto perative periods was recorded in 48,3 and 61,3%, respectively. Pneumonia is associated with respiratory failure, cardiac dysfunction, and anemia. The risk of COVID-19 pneumonia during the entire follow-up period was higher in patients with ACS who underwent CABG (odds ratio, 19,4; confidence interval: 13,3-26,1; p<0,001). The overall survival rate was 98,7%.Conclusion. COVID-19 infection in patients with ACS after MR effects pattern of postoperative complications. The proportion of COVID-19 pneumonia in patients with ACS in hospital, short- and long-term postoperative periods after MR significantly exceeds that in the general population. The leading factor associated with COVID-19 pneumonia in patients with ACS is on-pump CABG.

Clinical and Anamnestic Characteristics, Cardiovascular Pharmacotherapy and Long-term Outcomes in Multimorbid Patients after COVID-19

“…В настоящее время опубликован ряд работ, анализирующих ассоциацию коронавирусной инфекции COVID-19 и особенностей клинического течения, исходов у пациентов с сердечно-сосудистыми заболеваниями (ССЗ) и другой хронической патологией. Были получены данные о более высоком риске неблагоприятного прогноза у лиц с COVID-19 на фоне ССЗ [6][7][8][9][10][11][12][13][14], однако в этих исследованиях не анализировались клинические характеристики, кардиоваскулярная фармакотерапия и исходы у пациентов с КВММ, в том числе, по данным длительного наблюдения. Лишь в нескольких работах проводился анализ клинического течения и ведения пациентов, перенесших COVID-19 на фоне коморбидных состояний, а также отдаленных исходов [15][16][17].…”

Long-term outcomes in patients after COVID-19: data from the TARGET-VIP registry

“…и более) пациентов после перенесенного COVID-19 еще требует своего анализа. Большинство исследований имеют такие ограничения, как короткий срок наблюдения пациентов, недостаточно широкий охват исходов заболевания или ретроспективный дизайн [6][7][8]. Тем не менее в ближайшее время следует ожидать значительное количество публикаций по итогам длительного наблюдения больных, перенесших COVID-19, и с анализом отдаленных исходов.…”