Impact of the new coronavirus infection pandemic on the course of coronary heart disease

Abstract

This study analyzes the impact of the new coronavirus infection pandemic on the course of coronary heart disease. It highlights the role of factors such as endothelial dysfunction, microvascular hypoperfusion, thrombosis, and systemic inflammation in worsening cardiovascular pathology, including coronary heart disease. The paper also explores additional causes for the deterioration of coronary heart disease during the peak of the pandemic. Despite recommendations advocating for percutaneous intervention in all patients with acute coronary syndrome and S–T-segment elevation, there has been a notable decrease in the number of percutaneous intervention procedures performed during the peak of the pandemic. This decline is observed in patients with both S–T-segment elevation and those without (reductions of 21% and 37%, respectively). Despite the recommendations advocating for percutaneous intervention in all patients with acute coronary syndrome and S–T-segment elevation, there has been a notable decrease in the number of percutaneous intervention procedures performed during the peak of pandemic. This decline is observed in patients with both S–T-segment elevation and those without (reductions of 21% and 37%, respectively). Furthermore, there has been an increase in the time interval between ambulance contact and the execution of percutaneous procedures, resulting in prolonged myocardial ischemia and subsequently poorer patient prognosis. Moreover, due to limitations in the ability to provide inpatient examination and treatment for individuals with chronic heart failure, there has been a pronounced exacerbation of the condition and an increase in mortality rates. Similarly, the provision of cardiac rehabilitation after myocardial infarction has been significantly restricted. Given the extensive number of patients who have been affected or continue to suffer from new coronavirus infection, it is of utmost importance to develop predictive models that account for the development of post-new coronavirus infection syndrome and the emergence of early and late complications of a new coronavirus infection, including coronary artery disease, and comorbidities. The current risk assessment models, aimed at predicting mortality and guiding the treatment of patients with new coronavirus infection or post-infection, do not comprehensively consider all the necessary parameters nor do they predict the emergence of long-term complications. Therefore, further prospective studies are required to address these limitations.

Keywords

new coronavirus infection / coronary heart disease / myocardial infarction / heart failure / endothelial dysfunction / percutaneous interventions / cardiorehabilitation / circulatory system / postcovid syndrome

References

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