DOI: 10.25881/20728255_2022_17_4_2_30

Authors

Sukovatykh B.S.1, Nazarenkо P.M.1, Sukovatykh M.B.1, Bolomatov N.V. 2, 3, Sereditsky A.V.4, Sidorov D.V.4, Sereditsky I.A.4, Feyziev E.E.1

1 Kursk State Medical University, Kursk

2 Pirogov National Medical and Surgical Center, Moscow

3 Kursk City Clinical Hospital of Emergency Medical Care, Kursk

4 Orel Regional Clinical Hospital, Orel

Abstract

Objective: to study the state of coronary blood flow after percutaneous coronary intervention in patients with acute myocardial infarction on the background of coronavirus infectionм.

Materials and methods: The results of emergency intervention were analyzed in 50 patients with acute myocardial infarction, who were divided into 2 equal groups of 25 patients each. In the first (control) group, the intervention was performed in patients without the presence of an infectious disease, and in the second (main) group, angioplasty with coronary artery stenting was performed against the background of coronavirus infection. The efficiency of restoring coronary blood flow was determined according to the methodology for estimating the number of coronary angiography frames for which the revascularized artery was filled with a contrast agent: up to 20 –– complete restoration of coronary blood flow from 20 to 40 –– partial, over 40 frames –– unrecoverable. The number of thrombotic complications and deaths after the intervention was recorded.

Results: In the first group, the coronary blood flow was completely restored in 48%, partially in 40%, not restored in 12%, and in the second group, respectively, in 32%, 48% and 20% of patients. Thrombotic complications developed in the first group in 4% as a result of occlusion of the radial access artery. In the second group, 24% of patients had complications: occlusion of the radial in 12%, revascularized in 8%, adjacent previously traversed artery in 4%. There were no fatal outcomes in the first group, and in the second, in 8% of patients with coronary artery retrombosis, repeated intervention resulted in a fatal outcome.

Conclusion: coronavirus infection negatively affects coronary blood flow and increases the number of thrombotic complications.

Keywords: acute myocardial infarction, percutaneous coronary intervention, coronavirus infection, intensity of coronary blood flow, thrombotic complications.

References

1. Garcia S., Albahdadi M.S., Meraj P.M., et al. Decreased activity of laboratory cardiac catheterization with ST segment elevation in the USA during the COVID-19 pandemic. J Am Coll Cardiol. 2020; 75(22): 2871-2872. doi: 10.1016/j.jacc.2020.04.011.

2. De Filippo O, D’acenzo F, Angelini F, et al. Covid-19 in Northern Italy. N Engl J Med. 2020; 383(1): 88-89. doi: 10.1056/NEJMc2009166.

3. Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult patients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020; 395(10229): 1054-1062. doi: 10.1016/S0140-6736(20) 30566-3.

4. Li B, Yang J, Zhao F, et al. in China-vascular metabolic diseases on COVID-19 in China. Clin Res Cardiol. 2020; 109(5): 531-538. doi: 10.1007/s00392-020-01626-9.

5. Musher DM, Avers MS, Corrales-Medina VF. Acute infection and myocardial infarction. N Engl J Med. 2019; 380(2): 171-176. doi: 10.1056/NEJMra1808137.

6. De Rosa S, Spaccarotella S, Basso S, et al. Reduction of hospitalizations for myocardial infarction in Italy in the era of COVID-19. Eur Heart J. 2020; 41(22): 2083-2088. doi: 10.1093/eurheartj/ehaa409.

7. Chiffa A, Stefanini GG, Price S, et al. Statement of the EAPCI position on the invasive treatment of acute coronary syndromes during the COVID-19 pandemic. Eur Heart J. 2020; 41(19): 1839-1851. doi: 10.1093/eurheartj/ehaa381.

8. De Luca G, van’t Hof AW, Ottervanger JP, et al. Unsuccessful reperfusion in patients with ST-segment elevation myocardial infarction treated with primary angioplasty. Am. Heart J. 2005; 150: 557-562.

9. Mikhailova ZD, Klimkin PF. Cholesterol atheroembolism syndrome: current state of the problem. The Russian Archives of Internal Medicine. 2020; 10(4): 272-280. (In Russ.) doi: 10.20514/2226-6704-2020-10-4-272-280.

10. Gerasimov AM, Tereshchenko AS, Merkulov EV, Samko AN. No-reflow phenomenon in the practice of an endovascular surgeon. Bulletin of Radiology and Radiology. 2014; 1: 51-55. (In Russ.)

11. Vorobyeva OV, Lastochkin AV. Clinical and morphological case of COVID-19 // Epidemiology and infectious diseases. Current issues. 2020; 10(2): 90-93. (In Russ.) doi: https://doi.org/10.18565/ epidem.2020.2.90-93.

12. Dong E, Du H, Gardner L. An interactive web-based dashboard to track COVID-19 in real time. Lancet Infect. 2020; 20(5): 533-534. doi: 10.1016/S1473-3099(20)30120-1.

13. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020; 395(10): 497-506. doi: 10.1016/S0140-6736(20)30183-5.

14. Shevchenko YuL, Stoiko YuM, Gudymovich VG. Endothelium as a target of pathological effects of viral infection. Bulletin of the NMHC named after N.I. Pirogov. 2022; 17(2): 11-16. (In Russ.) doi: 10.25881/20728255_2022_17_2_11.

15. Rgeeb AN, Alsalkhet HA. Al. Effect of Intravenous Abciximab on Coronary Flow Improvement After Re-vascularization in Primary Coronary Intervention and Short Term Impact. Med Arch. 2020; 74(4): 265-269. doi: 10.5455/medarh. 2020.74.265-269.

For citation

Sukovatykh B.S., Nazarenkо P.M., Sukovatykh M.B., Bolomatov N.V. , Sereditsky A.V., Sidorov D.V., Sereditsky I.A., Feyziev E.E. The effect of coronavirus infection on coronary blood flow in endovascular treatment of acute myocardial infarction. Bulletin of Pirogov National Medical & Surgical Center. 2022;17(4-2):30-33. (In Russ.) https://doi.org/10.25881/20728255_2022_17_4_2_30