STUDY OF THE INFLUENCE OF ASSOCIATED PATHOLOGY ON INTERVENTIONAL TREATMENT OF ACUTE CORONARY SYNDROME DURING THE GLOBAL PANDEMIC OF COVID-19
DOI:
https://doi.org/10.11603/2414-4533.2024.4.15067Keywords:
percutaneous interventions, coronary bypass, SARS-CoV-2 virus, angiography, risk groupsAbstract
The aim of the work: to study the frequency of concomitant pathology in patients with acute coronary syndrome and its impact on interventional treatment during the COVID-19 pandemic.
Materials and Methods. The study included patients with acute coronary syndrome and manifestation of COVID-19 (n=100), the average age of the study participants was (63.5±4.8) years. All patients in this sample underwent myocardial revascularization procedures: percutaneous endovascular interventions (n=78) and coronary bypass surgery (n=22). The material for analysis was data from medical history, data from medical imaging methods: echocardiography and coronary angiography, protocols of percutaneous interventions and coronary bypass operations.
Results and Discussion. In the course of the study, the frequencies of the most common concomitant pathology, which is pathogenetically related to thromboembolism and increases the risk of a severe course, the development of complications, both in acute coronary syndrome and during the manifestation of COVID-19, were established. It was found that the frequency of type II diabetes (p=0.002, χ2=9.84) and heart rhythm disorders (p=0.02, χ2=5.23) were significantly higher among patients of the main group, and obesity, on the contrary, was significantly higher among patients of the comparison group, (p=0.001, χ2=10.17). Quantitative analysis of affected coronary arteries revealed that single-vessel (р=0.0001, χ2=21.10) and double-vessel (р=0.03, χ2=4.73) lesions significantly prevailed in patients of the main group, and the frequency of multivessel lesions was reliable higher in the comparison group (p=0.0001, χ2=129.29). It was established that the presence of type II diabetes, arterial hypertension, heart rhythm disorders and myocardial infarction significantly increased the risk of single-vessel and double-vessel lesions of the coronary arteries in patients of the main group, as evidenced by the calculated OR coefficients.
Conclusions. Based on the determination of reliable differences in the frequencies of the most common concomitant pathology that could initiate the development of acute coronary syndrome during the manifestation of COVID-19, the risks correlated with the number of coronary artery lesions were determined. It was established that the presence of type II diabetes, arterial hypertension, heart rhythm disorders and myocardial infarction significantly increased the risk of single-vessel lesions of the coronary arteries in patients of the main group. While the determined OR coefficients for type II diabetes, heart rhythm disorders, and myocardial infarction indicated an increased risk of developing acute coronary syndrome on the background of COVID-19 with two-vessel lesions of the coronary arteries.
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