The Effect of COVID-19 on the Perioperative Course of Acute Coronary Syndrome in Poland: The Estimation of Perioperative Prognosis and Neural Network Analysis in 243,515 Cases from 2020 to 2021

Abstract

COVID-19 causes thromboembolic complications that affect the patient’s prognosis. COVID‑19 vaccines significantly improve the prognosis for the course of the infection. The aim of this study was to evaluate the impacts of patient characteristics, including COVID-19 vaccinations, on perioperative mortality in acute coronary syndrome in Poland during the pandemic. We analyzed the data of 243,515 patients from the National Registry of Invasive Cardiology Procedures (Ogólnopolski Rejestr Procedur Kardiologii Inwazyjnej [ORPKI]). In this group, 7407 patients (21.74%) had COVID-19. The statistical analysis was based on a neural network that was verified by the random forest method. In 2020, the most significant impact on prognosis came from a diagnosis of unstable angina, a short period (<2 h) from pain occurrence to first medical contact, and a history of stroke. In 2021, the most significant factors were pre-hospital cardiac arrest, female sex, and a short period (<2 h) from first medical contact to coronary angiography. After adjusting for a six-week lag, a diagnosis of unstable angina and psoriasis were found to be relevant in the data from 2020, while in 2021, it was the time from the pain occurrence to the first medical contact (2–12 h) in non-ST segment elevation myocardial infarction and the time from first contact to balloon inflation (2–12 h) in ST-segment elevation myocardial infarction. The number of vaccinations was one of the least significant factors. COVID-19 vaccination does not directly affect perioperative prognosis in patients with acute coronary syndrome.

Risk stratification and prognosis prediction using cardiac biomarkers in COVID-19: a single-centre retrospective cohort study

“…An international registry among 3011 hospitalised COVID-19 patients reported cardiac incidence of 11.6% (acute coronary syndrome; 0.5%, type II cardiac ischaemia; 0.8%, heart failure; 1.8% and arrhythmia/conduction disorders; 8.6%) and pulmonary embolism; 6.6% 14. On the other hand, a neural network study using Polish National Registry of Invasive Cardiology Procedures reported that the COVID-19 infection had not affected periprocedural death in acute coronary syndrome and concluded that the evaluation of classic clinical risk factors is also important during the COVID-19 pandemic 15…”

Effect of COVID-19 pandemic on six-month mortality and clinical outcomes of patients with ST-elevation myocardial infarction

“…In a neural network model analysis of data collected from 161 catheterization laboratories in Poland throughout the year 2021, the most crucial variable for the prognosis of STEMI patients was the time from first medical contact to balloon inflation [ 18 ]. In the present study, there was no statistically significant difference between groups as regards the door-to-balloon or the total ischemic time.…”

Impact of Air Pollution and COVID-19 Infection on Periprocedural Death in Patients with Acute Coronary Syndrome

“…Patients from the pre-vaccination period were analyzed to eliminate the effect of vaccination on the studied parameters. A study of patients with ACS and the impact of vaccination was presented by our research team in another paper [ 26 ]. Correlations between acute coronary syndromes and various clinical, peri-procedural, and environmental factors have been studied by our team for several years [ 15 , 27 , 28 ].…”

“…Air pollution data obtained from the Main Environmental Protection Inspectorate were analyzed. Air pollutants recorded in 66 air monitoring stations in Poland were analyzed for their content of PM10, PM2.5, and heavy metals such as lead (Pb), nickel (Ni), cadmium (Cd) and arsenic (As) [ 26 ]. Daily data for each analyzed pollutant were obtained from the Chief Inspectorate of Environmental Protection for 66 stations in 16 provinces in Poland.…”