Milovančev Aleksandra, Petrović Milovan, Popadić Višeslav, Miljković Tatjana, Klašnja Slobodan, Djuran Predrag, Ilić Aleksandra, Kovačević Mila, Stojšić Milosavljević Anastazija, Brajković Milica, Crnokrak Bogdan, Memon Lidija, Milojević Ana, Todorović Zoran, Čanković Milenko, Lukić Šarkanović Mirka, Bjelić Snežana, Tadić Snežana, Redžek Aleksandar, Zdravković Marija
Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia.
Institute of Cardiovascular Diseases of Vojvodina, 21208 Sremska Kamenica, Serbia.
J Clin Med. 2022 Mar 24;11(7):1791. doi: 10.3390/jcm11071791.
Acute coronary syndrome (ACS) in patients with COVID-19 is triggered by various mechanisms and can significantly affect the patient’s further treatment and prognosis. The study aimed to investigate the characteristics, major complications, and predictors of mortality in COVID-19 patients with ACS. All consecutive patients hospitalized from 5 July 2020 to 5 May 2021 for ACS with confirmed SARS-Co-2 were prospectively enrolled and tracked for mortality until 5 June 2021. Data from the electronic records for age and diagnosis, matched non-COVID-19 and COVID-19 ACS group, were extracted and compared. Overall, 83 COVID-19 ACS patients, when compared to 166 non-COVID ACS patients, had significantly more prevalent comorbidities, unfavorable clinical characteristics on admission (acute heart failure 21.7% vs. 6.6%, p < 0.01) and higher rates of major complications, 33.7% vs. 16.8%, p < 0.01, and intrahospital 30-day mortality, 6.7% vs. 26.5%, p < 0.01. The strongest predictors of mortality were aortic regurgitation, HR 9.98, 95% CI 1.88; 52.98, p < 0.01, serum creatinine levels, HR 1.03, 95% CI 1.01; 1.04, p < 0.01, and respiratory failure therapy, HR 13.05, 95% CI 3.62; 47.01, p < 0.01. Concomitant ACS and COVID-19 is linked to underlying comorbidities, adverse presenting features, and poor outcomes. Urgent strategies are needed to improve the outcomes of these patients.
新型冠状病毒肺炎（COVID-19）患者的急性冠状动脉综合征（ACS）由多种机制引发，可显著影响患者的后续治疗及预后。本研究旨在调查COVID-19合并ACS患者的特征、主要并发症及死亡预测因素。对2020年7月5日至2021年5月5日期间因确诊感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）而住院治疗ACS的所有连续患者进行前瞻性登记，并追踪其至2021年6月5日的死亡率。提取并比较了年龄和诊断的电子记录数据，匹配了非COVID-19和COVID-19 ACS组。总体而言，83例COVID-19 ACS患者与166例非COVID ACS患者相比，合并症更为普遍，入院时临床特征较差（急性心力衰竭分别为21.7%和6.6%，p<0.01），主要并发症发生率更高（分别为33.7%和16.8%，p<0.01），院内30天死亡率更高（分别为6.7%和26.5%，p<0.01）。最强的死亡预测因素是主动脉反流，风险比（HR）为9.98，95%置信区间（CI）为1.88至52.98，p<0.01；血清肌酐水平，HR为1.03，95%CI为1.01至1.04，p<0.01；以及呼吸衰竭治疗，HR为13.05，95%CI为3.62至47.01，p<0.01。ACS与COVID-19并存与潜在合并症、不良表现特征及不良预后相关。需要采取紧急策略来改善这些患者的预后。
