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[Features of the course of non-ST elevation myocardial infarction in patients with a history of COVID-19].
Chashchin, M G; Gorshkov, A Yu; Drapkina, O M; Kositsyna, I V; Golubev, A V; Chaus, N I; Perekhodov, S N.
  • Chashchin MG; National Medical Research Center for Therapy and Preventive Medicine, Moscow; Demikhov Municipal Clinical Hospital, Moscow.
  • Gorshkov AY; National Medical Research Center for Therapy and Preventive Medicine, Moscow.
  • Drapkina OM; National Medical Research Center for Therapy and Preventive Medicine, Moscow.
  • Kositsyna IV; Demikhov Municipal Clinical Hospital, Moscow; Evdokimov Moscow State University of Medicine and Dentistry, Moscow.
  • Golubev AV; City Clinical Hospital named after V.P.Demikhov Moscow Moscow State University of Medicine and Dentistry named after A.I. Evdokimov.
  • Chaus NI; Demikhov Municipal Clinical Hospital, Moscow; Russian Medical Academy of Continuous Professional Education, Moscow.
  • Perekhodov SN; Demikhov Municipal Clinical Hospital, Moscow; Evdokimov Moscow State University of Medicine and Dentistry, Moscow.
Kardiologiia ; 62(5): 18-26, 2022 May 31.
Article in Russian | MEDLINE | ID: covidwho-2249747
ABSTRACT
Aim      To study the clinical course of non-ST segment elevation myocardial infarction (NSTEMI) in hospitalized patients after COVID-19 and to evaluate the effect of baseline characteristics of patients on the risk of complications.Material and methods  The study included 209 patients with NSTEMI; 104 of them had had COVID-19. The course of myocardial infarction (MI) was analyzed at the hospital stage, including evaluation of the incidence rate of complications (fatal outcome, recurrent MI, life-threatening arrhythmias and conduction disorders, pulmonary edema, cardiogenic shock, ischemic stroke, gastrointestinal bleeding).Results Mean age of patients after COVID-19 was 61.8±12.2 years vs. 69.0±13.0 in the comparison group (p<0.0001). The groups were comparable by risk factors, clinical data, and severity of coronary damage. Among those who have had СOVID-19, there were fewer patients of the GRACE high risk group (55.8 % vs. 74.3 %; p<0.05). Convalescent COVID-19 patients had higher levels of C-reactive protein and troponin I (p<0.05). The groups did not significantly differ in the incidence of unfavorable NSTEMI course (p>0.05). However, effects of individual factors (postinfarction cardiosclerosis, atrial fibrillation, decreased SpO2, red blood cell concentration, increased plasma glucose) on the risk of complications were significantly greater for patients after COVID-19 than for the control group (p<0.05).Conclusion      Patients with NSTEMI, despite differences in clinical history and laboratory data, are characterized by a similar risk of death at the hospital stage, regardless of the past COVID-19. Despite the absence of statistically significant differences in the incidence of in-hospital complications, in general, post-COVID-19 patients showed a higher risk of complicated course of NSTEMI compared to patients who had not have COVID-19. In addition, for this category of patients, new factors were identified that previously did not exert a clinically significant effect on the incidence of complications female gender, concentration of IgG to SARS-CoV-2 ≥200.0 U/l, concentration of С-reactive protein ≥40.0 mg/l, total protein <65 g/l. These results can be used for additional stratification of risk for cardiovascular complications in patients with MI and also for development of individual protocols for evaluation and management of NSTEMI patients with a history of COVID-19.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Non-ST Elevated Myocardial Infarction / ST Elevation Myocardial Infarction / COVID-19 / Myocardial Infarction Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Aged / Female / Humans / Middle aged Language: Russian Journal: Kardiologiia Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Non-ST Elevated Myocardial Infarction / ST Elevation Myocardial Infarction / COVID-19 / Myocardial Infarction Type of study: Diagnostic study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Aged / Female / Humans / Middle aged Language: Russian Journal: Kardiologiia Year: 2022 Document Type: Article