Pivina Lyudmila, Batenova Gulnara, Omarov Nazarbek, Ygiyeva Diana, Messova Assylzhan, Alibayeva Galiya, Jamedinova Ulzhan, Kurumbayev Ruslan, Pivin Maksim
Department of Emergency Medicine, Semey Medical University, Semey, Abay Region, Kazakhstan.
Semey Emergency Hospital, Semey, Abay Region, Kazakhstan.
Open Access Emerg Med. 2025 Jan 22;17:15-30. doi: 10.2147/OAEM.S470523. eCollection 2025.
One of the most serious complications of coronary artery stenting is restenosis and in-stent thrombosis; their prevalence can reach 20-25%. Stent thrombosis can be acute (up to 24 hours), subacute (24 hours to 30 days), late (30 days to 1 year), and very late (> 1 year after previous stenting). In the patients with COVID-19 in intensive care units, the proportion of those with elevated troponin levels reached 25%.
Evaluation of the association between COVID-19 and the development of in-stent thrombosis and restenosis of the coronary arteries based on the analysis of clinical cases and case series.
We searched the PubMed and Scopus databases for relevant case reports and case series of stent restenosis and in-stent thrombosis associated with coronavirus infection (CVI) published between 2020 and the present. Thirty-eight full-text publications were screened and manually checked for analysis. We found 10 publications describing cases of thrombosis and restenosis of stents associated with coronavirus infection, of which only 2 were case series. In total, we analyzed 22 cases.
In the structure of in-stent restenosis and thrombosis, 59.1% were very late, 9.1% were late; 18.2% were considered subacute events, and 13.6% were acute events. All cases were angiographically confirmed. The main location of restenosis or thrombosis was the left coronary artery (LAD) (51.1%), thrombosis of the right coronary artery (RCA) occurred in 27.3%, and location in circumflex artery was in 22.7%. All patients had COVID-19 confirmed by a PCR test or the presence of immunoglobulins G and M. In fourteen patients (54.5%), an X-ray examination showed the presence of bilateral polysegmental infiltration.
Analysis of publications demonstrates the association between restenosis and in-stent thrombosis in patients with coronary arteries disease (CAD) and coronavirus infection.
冠状动脉支架置入术最严重的并发症之一是再狭窄和支架内血栓形成；其发生率可达20%-25%。支架内血栓形成可分为急性（至24小时）、亚急性（24小时至30天）、晚期（30天至1年）和极晚期（上次支架置入术后>1年）。在重症监护病房的新冠肺炎患者中，肌钙蛋白水平升高的患者比例达25%。
基于临床病例和病例系列分析，评估新冠肺炎与冠状动脉支架内血栓形成及再狭窄发生之间的关联。
我们在PubMed和Scopus数据库中检索了2020年至今发表的与冠状病毒感染（CVI）相关的支架再狭窄和支架内血栓形成的相关病例报告和病例系列。筛选出38篇全文出版物并进行人工检查以进行分析。我们发现10篇描述与冠状病毒感染相关的支架血栓形成和再狭窄病例的出版物，其中只有2篇是病例系列。我们总共分析了22例病例。
在支架内再狭窄和血栓形成的构成中，59.1%为极晚期，9.1%为晚期；18.2%被视为亚急性事件，13.6%为急性事件。所有病例均经血管造影证实。再狭窄或血栓形成的主要部位是左冠状动脉（LAD）（51.1%），右冠状动脉（RCA）血栓形成占27.3%，回旋支血栓形成占22.7%。所有患者均通过PCR检测确诊为新冠肺炎或存在免疫球蛋白G和M。14例患者（54.5%）的X线检查显示存在双侧多节段浸润。
出版物分析表明，冠状动脉疾病（CAD）患者与冠状病毒感染之间存在再狭窄和支架内血栓形成的关联。
