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新型冠状病毒肺炎阳性急性冠状动脉综合征患者经皮冠状动脉介入治疗的结果:越南的一项回顾性研究

Outcomes of percutaneous coronary intervention in COVID-19-positive acute coronary syndrome patients: a retrospective study in Vietnam.

作者信息

Le Duy Cao Phuong, Nguyen Nguyet Thi Minh, Vo Quan Duy

机构信息

Department of Cardiovascular Intervention, Nguyen Tri Phuong Hospital, Ho Chi Minh City, Vietnam.

Faculty of Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam.

出版信息

Front Cardiovasc Med. 2025 Jul 10;12:1563415. doi: 10.3389/fcvm.2025.1563415. eCollection 2025.

DOI:10.3389/fcvm.2025.1563415
PMID:40709202
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12286974/
Abstract

BACKGROUND

Coronavirus disease 2019 (COVID-19) has disrupted the management of acute coronary syndrome (ACS), with emerging evidence suggesting increased complications and mortality among patients undergoing percutaneous coronary intervention (PCI). However, data from low- and middle-income settings such as Vietnam remain limited. This study aimed to evaluate the clinical characteristics and outcomes of ACS patients with COVID-19 undergoing PCI at a tertiary hospital in Vietnam.

METHODS

This retrospective cohort study was conducted at a tertiary hospital in Ho Chi Minh City from 2019 to 2022. Adult patients diagnosed with ACS who underwent PCI were included and stratified by COVID-19 status confirmed via RT-PCR. All patients received standard guideline-directed therapy, including dual antiplatelet and anticoagulant regimens, and were followed for 1 year to assess clinical outcomes.

RESULT

A total of 118 patients were included, comprising 26 COVID-19-positive and 92 COVID-19-negative individuals. Baseline characteristics and cardiovascular risk factors were generally comparable between the two groups. While procedural success rates were similar, COVID-19-positive patients demonstrated higher thrombus burden and significantly increased rates of ICU admission, prolonged hospitalization, and MACCE at all timepoints. COVID-19 severity, cardiogenic shock, and multivessel disease emerged as independent predictors of adverse outcomes.

CONCLUSION

In this Vietnamese cohort, COVID-19 infection was associated with worse clinical outcomes following PCI for ACS. These findings highlight the need for early risk stratification and resource planning during pandemic conditions. However, the small sample size, single-center design, and observational nature of the study limit its generalizability, and causal inferences should be drawn with caution.

摘要

背景

2019年冠状病毒病(COVID-19)扰乱了急性冠状动脉综合征(ACS)的管理,新出现的证据表明,接受经皮冠状动脉介入治疗(PCI)的患者并发症和死亡率增加。然而,来自越南等低收入和中等收入地区的数据仍然有限。本研究旨在评估越南一家三级医院中接受PCI的COVID-19合并ACS患者的临床特征和预后。

方法

本回顾性队列研究于2019年至2022年在胡志明市的一家三级医院进行。纳入诊断为ACS并接受PCI的成年患者,并根据逆转录聚合酶链反应(RT-PCR)确诊的COVID-19状态进行分层。所有患者均接受标准的指南导向治疗,包括双联抗血小板和抗凝方案,并随访1年以评估临床结局。

结果

共纳入118例患者,其中26例COVID-19阳性,92例COVID-19阴性。两组的基线特征和心血管危险因素总体相当。虽然手术成功率相似,但COVID-19阳性患者在所有时间点均显示出更高的血栓负荷,以及ICU入住率、住院时间延长和主要不良心血管和脑血管事件(MACCE)发生率显著增加。COVID-19严重程度、心源性休克和多支血管病变是不良结局的独立预测因素。

结论

在这个越南队列中,COVID-19感染与ACS患者PCI术后更差的临床结局相关。这些发现凸显了在大流行期间进行早期风险分层和资源规划的必要性。然而,本研究样本量小、单中心设计以及观察性研究性质限制了其普遍性,应谨慎做出因果推断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b49a/12286974/a32bf085a89b/fcvm-12-1563415-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b49a/12286974/a32bf085a89b/fcvm-12-1563415-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b49a/12286974/a32bf085a89b/fcvm-12-1563415-g001.jpg

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