Department of Cardiology, 560754Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom.
Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, 4617Queen Mary University of London, London, United Kingdom.
J Cardiovasc Pharmacol Ther. 2021 May;26(3):203-216. doi: 10.1177/1074248420982736. Epub 2020 Dec 17.
Although COVID-19 is viewed primarily as a respiratory disease, cardiovascular risk factors and disease are prevalent among infected patients and are associated with worse outcomes. In addition, among multiple extra-pulmonary manifestations, there has been an increasing recognition of specific cardiovascular complications of COVID-19. Despite this, in the initial stages of the pandemic there was evidence of a reduction in patients presenting to acute cardiovascular services. In this masterclass review, with the aid of 2 exemplar cases, we will focus on the important therapeutic implications of COVID-19 for interventional cardiologists. We summarize the existing evidence base regarding the varied cardiovascular presentations seen in COVID-19 positive patients and the prognostic importance and potential mechanisms of acute myocardial injury in this setting. Importantly, through the use of a systematic review of the literature, we focus our discussion on the observed higher rates of coronary thrombus burden in patients with COVID-19 and acute coronary syndromes.
虽然 COVID-19 主要被视为一种呼吸道疾病,但心血管危险因素和疾病在感染患者中普遍存在,并与更差的结局相关。此外,在多种肺外表现中,人们越来越认识到 COVID-19 的特定心血管并发症。尽管如此,在大流行的早期阶段,有证据表明,到急性心血管服务就诊的患者减少了。在本次大师班综述中,我们将借助 2 个范例病例,重点关注 COVID-19 对介入心脏病学家的重要治疗意义。我们总结了 COVID-19 阳性患者中出现的各种心血管表现的现有证据基础,以及急性心肌损伤在这种情况下的预后重要性和潜在机制。重要的是,通过对文献的系统回顾,我们将讨论重点放在 COVID-19 患者和急性冠状动脉综合征中观察到的更高的冠状动脉血栓负荷率上。