The role of anticoagulation in preventing myocardial infarction and improving outcomes in COVID-19 patients.
Herzschrittmacherther Elektrophysiol
; 32(3): 365-370, 2021 Sep.
Article
in English
| MEDLINE | ID: covidwho-1315331
ABSTRACT
BACKGROUND:
Coronavirus disease 2019 (COVID-19) is associated with cardiovascular (CV) complications including myocardial injury, myocarditis, arrhythmias, and venous thromboembolism. The infection is more severe in patients with pre-existing cardiovascular disease (CVD), where systemic inflammation due to cytokine storm, hypercoagulation, as well as high hematocrit and platelet (PLT) count may contribute to an increased CV risk. The authors hypothesize that anticoagulants and antiplatelets prevent miocardial infarction (MI) in patients with pre-existing CVD.METHODS:
A cohort study enrolled patients with a confirmed diagnosis of COVID-19. Clinical and laboratory data, total and CV mortality, as well as MI incidence and treatment regimens were compared according to the time of hospitalization 40-day period in April-May (Group 1) and in October-November (Group 2).RESULTS:
A total of 195 patients were enrolled 93 in Group 1, with 36.5%, and 102 in Group 2 with 38.2% pre-existing CVD. Group 1 was managed with infusion therapy; only 10.7% received anticoagulation. Group 2 received preventive anticoagulants, antiplatelets, and infusion therapy. In Group 1, seven cases of MI were recorded compared to only three in Group 2. No significant difference in overall mortality (4.3% vs 6.86%, pâ¯= 0.441) and MI incidence (7.5% vs 2.9%, pâ¯= 0.149) was found, but significant differences were seen in the incidence of severe and critically ill cases between the groups (69.9% and 7.5% vs 75.5% and 20.6%, pâ¯< 0.001).CONCLUSIONS:
Poorer outcomes in the early COVID-19 wave were associated with inadequate anticoagulation due to lack of knowledge about the new virus. Despite significantly more severe cases, there was no significant difference in overall mortality and MI incidence in patients with anticoagulation.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
COVID-19
/
Myocardial Infarction
Type of study:
Cohort study
/
Experimental Studies
/
Observational study
/
Prognostic study
/
Randomized controlled trials
Limits:
Humans
Language:
English
Journal:
Herzschrittmacherther Elektrophysiol
Journal subject:
Cardiology
/
Physiology
Year:
2021
Document Type:
Article
Affiliation country:
S00399-021-00786-z
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