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COVID-19 患者中 STEMI 的特定特征及其实际意义。

Specific characteristics of STEMI in COVID-19 patients and their practical implications.

机构信息

Department of Biomedical Sciences, Humanitas University, Pieve Emanuele-Milan, Milan, Italy.

Humanitas Research Hospital IRCCS, Rozzano-Milan, Italy.

出版信息

Kardiol Pol. 2022;80(3):266-277. doi: 10.33963/KP.a2022.0072. Epub 2022 Mar 25.

Abstract

ST-elevation myocardial infarction (STEMI) is one of the cardiac emergencies whose management has been most challenged by the COVID-19 pandemic. Patients presenting with the "lethal combo" of STEMI and concomitant SARS-CoV-2 infection have faced dramatic issues related to the need for self-isolation, systemic inflammation with multi-organ disease and difficulties to obtain timely diagnosis and treatment. The interplay between these and other factors has partly neutralized the major advances in STEMI care achieved in the last decades, significantly impairing prognosis in these patients. In the present review article, we will provide an overview on mechanisms of myocardial injury, specific clinical and angiographic characteristics and contemporary management in different settings of STEMI patients with COVID-19, alongside the inherent implications in terms of in-hospital mortality and short-term clinical outcomes.

摘要

ST 段抬高型心肌梗死(STEMI)是心脏急症之一,在 COVID-19 大流行期间,其管理受到了最大的挑战。同时患有 STEMI 和 SARS-CoV-2 感染的患者面临着与自我隔离、全身炎症伴多器官疾病以及难以及时诊断和治疗相关的巨大问题。这些因素和其他因素之间的相互作用在一定程度上削弱了过去几十年在 STEMI 治疗方面取得的重大进展,显著影响了这些患者的预后。在本综述文章中,我们将概述心肌损伤的机制、伴有 COVID-19 的 STEMI 患者的特定临床和血管造影特征以及在不同情况下的当代治疗方法,以及其对住院死亡率和短期临床结局的内在影响。

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