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Zeldetz V, Shashar S, Cafri C, Shamia D, Slutsky T, Abu Abed N, Schwarzfuchs D. STEMI in Times of Crisis: Comparative Analysis During Pandemic and War. J Clin Med 2025; 14:1720. [PMID: 40095790 PMCID: PMC11900518 DOI: 10.3390/jcm14051720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2025] [Revised: 02/18/2025] [Accepted: 03/01/2025] [Indexed: 03/19/2025] Open
Abstract
Background: Crises such as pandemics and wars significantly impact cardiovascular health, particularly ST-Elevation Myocardial Infarction (STEMI). The COVID-19 pandemic led to overwhelmed healthcare systems and delayed care, while the October 2023 war in Israel posed unique challenges, including altered patient behavior and access to care. This study compares STEMI outcomes during these two crisis periods, focusing on mortality and care pathways. Methods: This retrospective cohort study, conducted at Soroka University Medical Center, analyzed patients with STEMI during the COVID-19 lockdown (14 March 2020-14 June 2020), the war period (07 October 2023-7 January 2024), and quiet periods in 2022. Patient demographics, arrival methods, and outcomes were compared. Multivariable logistic regression identified mortality predictors. Results: Among 397 patients with STEMI, 30-day mortality was 7.5 times higher during COVID-19 (OR 7.50, p = 0.038), and in-hospital mortality was 10.25 times higher (OR 10.25, p = 0.046) compared to the war. The war period showed an 86% reduction in 30-day mortality (OR 0.14, p = 0.026). More patients arrived by ambulance during COVID-19, while during the war, more were referred via emergency medical centers and admitted directly to the ICCU. Conclusions: The COVID-19 pandemic significantly increased STEMI mortality, while the war's coordinated care pathways improved outcomes. Tailored crisis management strategies are important to ensure effective acute care during pandemics and conflicts.
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Affiliation(s)
- Vladimir Zeldetz
- Department of Emergency Medicine, Soroka University Medical Center, Beer-Sheva 84101, Israel; (V.Z.); (T.S.); (N.A.A.); (D.S.)
| | - Sagi Shashar
- Clinical Research Center, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 84101, Israel
| | - Carlos Cafri
- Department of Cardiology, Soroka University Medical Centre, Beer Sheva 84101, Israel; (C.C.); (D.S.)
| | - David Shamia
- Department of Cardiology, Soroka University Medical Centre, Beer Sheva 84101, Israel; (C.C.); (D.S.)
| | - Tzachi Slutsky
- Department of Emergency Medicine, Soroka University Medical Center, Beer-Sheva 84101, Israel; (V.Z.); (T.S.); (N.A.A.); (D.S.)
- Hospital Administration, Soroka University Medical Center, Beer Sheva 84101, Israel
| | - Naif Abu Abed
- Department of Emergency Medicine, Soroka University Medical Center, Beer-Sheva 84101, Israel; (V.Z.); (T.S.); (N.A.A.); (D.S.)
| | - Dan Schwarzfuchs
- Department of Emergency Medicine, Soroka University Medical Center, Beer-Sheva 84101, Israel; (V.Z.); (T.S.); (N.A.A.); (D.S.)
- Hospital Administration, Soroka University Medical Center, Beer Sheva 84101, Israel
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2
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Du J, Wang T, Xu L. HIF‑1α overexpression improves the efficacy of human induced pluripotent stem cell‑derived cardiomyocytes for cardiac repair following myocardial infarction. Mol Med Rep 2025; 31:40. [PMID: 39611463 PMCID: PMC11626424 DOI: 10.3892/mmr.2024.13405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2024] [Accepted: 10/22/2024] [Indexed: 11/30/2024] Open
Abstract
Myocardial infarction (MI) is the leading cause of death worldwide and currently there are limited therapies that can regenerate the lost cardiac cells following MI. To enhance the therapeutic effects of human induced pluripotent stem cell‑derived cardiomyocytes (hiPSC‑CM) transplantation for treatment of MI, the present study sought to increase the pro‑angiogenic effect of hiPSC‑CM by overexpressing a mutated hypoxia‑inducible factor 1‑alpha (HIF‑1α; P402A; P564A) via lentivirus transfection. Morphology and the electrophysiology of the genetically engineered cell were both unchanged. The present study demonstrated that the proangiogenic factors in the conditioned medium of the HIF‑1α‑overexpressing hiPSC‑CM (HIF‑CM) were upregulated and subsequently resulted to the rescue of the tube forming ability and migratory ability of the hypoxia‑injured human umbilical vein endothelial cells. Using a MI mouse model, the present study demonstrated that the transplantation of HIF‑CM greatly improved cardiac function, decreased scar size, promoted the concentration of the proangiogenic factors in circulation and promoted the neovessel formation in mice with MI. In conclusion, HIF‑1α‑overexpressing hiPSC‑CM could increase the angiogenesis of endothelial cells and mediate cardioprotection in mouse following MI.
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Affiliation(s)
- Jianfeng Du
- Department of Cardiology, The Fourth People's Hospital of Shenyang, Shenyang, Liaoning 110000, P.R. China
| | - Tianbao Wang
- Department of Cardiology, The Fourth People's Hospital of Shenyang, Shenyang, Liaoning 110000, P.R. China
| | - Liqing Xu
- Department of Cardiology, The Fourth People's Hospital of Shenyang, Shenyang, Liaoning 110000, P.R. China
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Sato H, Yonezu K, Saito S, Abe I, Tawara K, Akioka H, Shinohara T, Teshima Y, Yufu K, Abe R, Shimomura T, Takahashi N. The Long-Term Impact of the COVID-19 Pandemic on the Prognosis of Patients With Acute Myocardial Infarction in Japan. Cureus 2025; 17:e77918. [PMID: 39991383 PMCID: PMC11847558 DOI: 10.7759/cureus.77918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2025] [Indexed: 02/25/2025] Open
Abstract
BACKGROUND The prognosis of patients with acute myocardial infarction (AMI) in the initial stage of the coronavirus disease 2019 (COVID-19) outbreak has been reported globally. However, the reports on the prognosis of patients with AMI after the initial stage of the pandemic are limited worldwide. METHODS This retrospective observational study utilized data from the electronic medical records system of the Oita University Hospital. This study encompassed patients who were hospitalized at our hospital for AMI treatment between April 2018 and June 2022. The study period was categorized into the following three periods: the pre-pandemic period (April 2018 to March 2020), the first phase of the pandemic (April 2020 to March 2021), and the second phase of the pandemic (April 2021 to June 2022). The primary outcome was the duration from the initial admission for AMI treatment to the onset of major adverse cardiac events (MACE). The secondary outcome was the duration from the initial admission for AMI treatment to death from any cause. These outcomes were compared among patients with AMI admitted during the three periods. RESULTS The one-year MACE-free survival rates did not differ significantly among the three periods (p = 0.146), whereas the one-year overall survival rates were significantly different (p = 0.022). Univariate Cox regression analysis showed that patients with AMI had poorer overall survival in the second phase of the COVID-19 pandemic compared to the pre-pandemic period (hazard ratio {HR}: 4.92, 95% confidence interval {CI}: 1.27-19.09, p = 0.021). However, multiple regression analysis did not show significant differences in the overall survival of patients with AMI across the three periods (HR: 2.77, 95% CI: 0.59-12.96, p = 0.196). CONCLUSION The long-term impact of the COVID-19 pandemic on the prognosis of patients with AMI remains unclear. Further research is required to clarify the long-term impact by using larger cohorts that include pre-hospital data.
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Affiliation(s)
- Hiroki Sato
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu, JPN
| | - Keisuke Yonezu
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu, JPN
| | - Shotaro Saito
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu, JPN
| | - Ichitaro Abe
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu, JPN
| | - Katsunori Tawara
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu, JPN
| | - Hidefumi Akioka
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu, JPN
| | - Tetsuji Shinohara
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu, JPN
| | - Yasushi Teshima
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu, JPN
| | - Kunio Yufu
- Department of Cardiology, Oita Red Cross Hospital, Oita, JPN
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu, JPN
| | - Ryuzo Abe
- Department of Emergency Medicine, Faculty of Medicine, Oita University, Yufu, JPN
| | - Tsuyoshi Shimomura
- Department of Medical Informatics, Faculty of Medicine, Oita University, Yufu, JPN
| | - Naohiko Takahashi
- Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University, Yufu, JPN
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4
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El-Menyar A, Ramzee AF, Asim M, Shahid F, Ata YM, El Baba H, Fino A, Nair AP, Peralta R, Almaslamani MA, Al Suwaidi J, Al-Thani H, Rizoli S. COVID-19 Increases the Risk of New Myocardial Infarction in Patients with Old Myocardial Infarction: A Retrospective Observational Study. CLINICAL MEDICINE INSIGHTS-CARDIOLOGY 2024; 18:11795468241301133. [PMID: 39697349 PMCID: PMC11653445 DOI: 10.1177/11795468241301133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Accepted: 10/07/2024] [Indexed: 12/20/2024]
Abstract
Background We aimed to investigate the incidence of new acute myocardial infarction (AMI), in patients with Coronavirus disease (COVID-19) who had old MI. We hypothesized that COVID-19 increases the rate of repeated AMI in this population regardless of age and gender. Methods A retrospective analysis was conducted for adult patients admitted with COVID-19 and developed thromboembolic event (TEE) in 2020. Patients were categorized based on the history of old MI, new MI, age, and gender. Results Among 16,903 patients with COVID-19 who were admitted, 210 (1.2%) developed TEE (89% were males, 55% were <55 years old, and 80.5% had an old MI). COVID-19 was severe in 32% of cases. AMI occurred in 160 patients (42.5% STEMI and 57.5% NSTEMI). In patients with prior MI, 92.5% developed another AMI. NSTEMI was higher in patients with severe COVID-19 than STEMI (33% vs 21%). Patients with severe COVID-19 had higher mortality (39.4% vs 5.6%), fewer rates of prior MI (74% vs 83%), hypertension (40% vs 60%), and STEMI (31.8% vs 46.5%) than mild COVID-19 patients. On multivariable analysis, COVID-19 severity was an independent predictor of mortality (OR10; 95%CI 1.62-67.19) after adjustment for age, gender, diabetes mellitus, C-reactive protein, serum Ferritin, Procalcitonin, and Fibrinogen values, and prior or new MI. Conclusions Patients with old MI could develop a new AMI in 80% of COVID-19. However, the mortality was higher in patients without a history of MI due to the severity of COVID-19. Attention should be given to patients who possess thrombotic risk factors in pandemics.
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Affiliation(s)
- Ayman El-Menyar
- Clinical Research, Trauma and Vascular Surgery, Hamad Medical Corporation, Doha, Qatar
- Clinical Medicine, Weill Cornell Medical College, Doha, Qatar
| | | | - Mohammad Asim
- Clinical Research, Trauma and Vascular Surgery, Hamad Medical Corporation, Doha, Qatar
| | - Fakhar Shahid
- Department of Surgery, Hamad Medical Corporation, Doha, Qatar
| | - Yaser M Ata
- Department of Surgery, Hamad Medical Corporation, Doha, Qatar
| | - Hamzah El Baba
- Department of Surgery, Hamad Medical Corporation, Doha, Qatar
| | - Areen Fino
- Department of Family Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Arun P Nair
- Communicable Disease Center (CDC), Hamad Medical Corporation, Doha, Qatar
| | - Ruben Peralta
- Trauma Surgery Section, Hamad Medical Corporation, Doha, Qatar
- Department of Surgery, Universidad Nacional Pedro Henriquez Urena, Santo Domingo, Dominican Republic
| | - Muna A Almaslamani
- Communicable Disease Center (CDC), Hamad Medical Corporation, Doha, Qatar
| | - Jassim Al Suwaidi
- Department of Cardiology, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Hassan Al-Thani
- Trauma Surgery Section, Hamad Medical Corporation, Doha, Qatar
| | - Sandro Rizoli
- Trauma Surgery Section, Hamad Medical Corporation, Doha, Qatar
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Blasco A, Royuela A, García-Gómez S, Gómez-Lozano N, Sánchez-Arjona A, de la Fuente J, Anel J, Sánchez-Galarraga I, Pérez-Redondo M, González E, Silva L. Association of SARS-CoV-2 immunoserology and vaccination status with myocardial infarction severity and outcome. Vaccine 2024; 42:126305. [PMID: 39244425 DOI: 10.1016/j.vaccine.2024.126305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2024] [Revised: 08/27/2024] [Accepted: 08/28/2024] [Indexed: 09/09/2024]
Abstract
BACKGROUND The COVID-19 pandemic adversely affected the severity and prognosis of patients with acute myocardial infarction (MI) caused by atherothrombosis (type 1 MI). The effect, if any, of COVID-19 vaccination and natural SARS-CoV2 serologic immunity in these patients is unclear. Our aim was to analyze the association between the severity and outcome of patients with type 1 MI and their previous SARS-CoV2 vaccination and serostatus. METHODS A single-center retrospective cohort study conducted between March 1, 2020 and March 1, 2023. Clinical and follow-up information was collected from medical records and patients. Total antibodies (IgM, IgA, IgG) to nucleocapsid (N) antigens were measured by ECLIA (electrochemiluminescence-based immunoassay) to test the immune response to natural infection. If positive, IgM and IgG antibodies to spike (S) surface antigens were measured by CLIA to test the immune response to vaccine or natural infection. Multivariable logistic regression analysis was performed, adjusting for age, sex, hypertension, diabetes, and dyslipidemia. RESULTS Total sample of 949 patients, 656 with ST-segment elevation MI (STEMI) and 293 with non-ST-segment elevation MI (NSTEMI). Mean age was 64 (SD 13) years, 80 % men. Pre-admission vaccination status was: ≥ 1 dose, 53 % of patients; complete vaccination, 49 %; first booster dose, 25 %. The majority (84 %) of vaccines administered were mRNA-based. Six months after MI, 92 (9.7 %) patients had a major adverse cardiac event (MACE) and 50 died; 11 % of patients had severe heart failure or cardiogenic shock (Killip III-IV) after STEMI. Vaccinated patients with STEMI and positive serology (Pos/Vax group) had a higher risk of Killip III-IV on admission: OR 2.63 (1.27-5.44), p = 0.010. SARS-CoV-2 S-specific IgG titers were highest in this group (median > 2080 AU/mL, [IQR 1560- >2080] vs 91 [32-198] in the unvaccinated group). In the overall sample, a higher incidence of 6-month MACE was not demonstrated (OR 1.89 [0.98-3.61], p = 0.055). CONCLUSIONS The combination of vaccination and natural SARS-CoV2 infection was associated with the development of severe heart failure and cardiogenic shock in patients with STEMI, possibly related to an increased serological response.
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Affiliation(s)
- Ana Blasco
- Cardiology Department, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain; Research Ethics Committee, Instituto de Investigación Puerta de Hierro-Segovia de Arana, Madrid, Spain.
| | - Ana Royuela
- Biostatistics Unit, Instituto de Investigación Puerta de Hierro-Segovia de Arana, Madrid, Spain; Center for Biomedical Research in Epidemiology and Public Health Network (CIBERESP), Madrid, Spain
| | - Sergio García-Gómez
- Cardiology Department, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Natalia Gómez-Lozano
- Immunology Department, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Alberto Sánchez-Arjona
- Cardiology Department, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Jorge de la Fuente
- Cardiology Department, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Jorge Anel
- Microbiology Department, Serology Section, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | | | - Marina Pérez-Redondo
- Intensive Care Unit, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Elisa González
- Cardiology Department, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Lorenzo Silva
- Cardiology Department, Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
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Kimura M, Matoba T, Nakano Y, Katsuki S, Sakamoto K, Nishihara M, Nagata T, Tahara Y, Nagao K, Okura H, Ikeda T, Nakai M, Tsutsui H. Impact of the Coronavirus Disease 2019 (COVID-19) Pandemic on the Severity and the Mortality of Acute Myocardial Infarction in Japan - Analysis From the JROAD-DPC Database. Circ Rep 2024; 6:191-200. [PMID: 38860181 PMCID: PMC11162853 DOI: 10.1253/circrep.cr-24-0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 03/29/2024] [Accepted: 04/04/2024] [Indexed: 06/12/2024] Open
Abstract
Background: Coronavirus disease 2019 (COVID-19) has impacted on cardiovascular disease. However, it remains unclear whether the COVID-19 pandemic has impacted on disease severity and patients' prognosis of acute myocardial infarction (AMI) in Japan. Methods and Results: We retrospectively accumulated data from the Japanese Registry of All Cardiac and Vascular Diseases-Diagnosis Procedure Combination (JROAD-DPC) study (April 2019 to March 2021). Patients were divided into a before COVID-19 pandemic group or a during COVID-19 pandemic group. The proportion of patients who presented with cardiogenic shock (Killip class IV) was compared between groups, in association with 30-day mortality as the primary outcome. Killip class IV AMI significantly increased in the during COVID-19 pandemic group (15.7% vs. 14.5% in the before pandemic group, P<0.0001). The 30-day mortality was higher in the during COVID-19 pandemic group (9.6% vs. 9.2% in the before COVID-19 pandemic group, P=0.049). However, there was no significant difference in the adjusted 30-day mortality in each Killip class between the before and during COVID-19 pandemic groups. Conclusions: During the early stage of the COVID-19 pandemic in Japan, 30-day mortality of AMI increased, mainly because of the increase of Killip class IV AMI patients. However, irrespective of the COVID-19 pandemic, the adjusted 30-day mortality of each Killip classification group was unchanged.
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Affiliation(s)
- Mitsukuni Kimura
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medicine Fukuoka Japan
| | - Tetsuya Matoba
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medicine Fukuoka Japan
| | - Yasuhiro Nakano
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medicine Fukuoka Japan
| | - Shunsuke Katsuki
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medicine Fukuoka Japan
| | - Kazuo Sakamoto
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medicine Fukuoka Japan
| | - Masaaki Nishihara
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medicine Fukuoka Japan
| | - Takuya Nagata
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medicine Fukuoka Japan
| | - Yoshio Tahara
- National Cerebral and Cardiovascular Center Suita Japan
| | - Ken Nagao
- Cardiovascular Center, Nihon University Hospital Tokyo Japan
| | | | - Takanori Ikeda
- Department of Cardiovascular Medicine, Toho University Tokyo Japan
| | - Michikazu Nakai
- Clinical Research Support Center, University of Miyazaki Hospital Miyazaki Japan
| | - Hiroyuki Tsutsui
- Department of Cardiovascular Medicine, Kyushu University Faculty of Medicine Fukuoka Japan
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Sofi F, Dinu M, Reboldi G, Lotti S, Genovese L, Tritto I, Gensini G, Gibson CM, Ambrosio G. Worldwide impact of COVID-19 on hospital admissions for non-ST-elevation acute coronary syndromes (NSTACS): a systematic review with meta-analysis of 553 038 cases. EUROPEAN HEART JOURNAL. QUALITY OF CARE & CLINICAL OUTCOMES 2024; 10:265-283. [PMID: 37580157 PMCID: PMC11112522 DOI: 10.1093/ehjqcco/qcad048] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 08/03/2023] [Accepted: 08/11/2023] [Indexed: 08/16/2023]
Abstract
BACKGROUND How coronavirus disease 2019 (COVID-19) impacted non-ST-segment elevation acute coronary syndromes (NSTACS) is an object of controversial reports. AIM To systematically review studies reporting NSTACS hospitalizations during the COVID-19 pandemic, and analyse whether differences in COVID-19 epidemiology, methodology of report, or public health-related factors could contribute to discrepant findings. METHODS Comprehensive search (Medline, Embase, Scopus, Web of Science, Cochrane Register), of studies reporting NSTACS hospitalizations during the COVID-19 pandemic compared with a reference period, following Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. Data were independently extracted by multiple investigators and pooled using a random-effects model. Health-related metrics were from publicly available sources, and analysed through multiple meta-regression modelling. RESULTS We retrieved 102 articles (553 038 NSTACS cases, 40 countries). During peak COVID-19 pandemic, overall incidence rate ratio (IRR) of NSTACS hospitalizations over reference period decreased (0.70, 95% confidence interval (CI) 0.66-0.75; P < 0.00001). Significant heterogeneity was detected among studies (I2 = 98%; P < 0.00001). Importantly, wide variations were observed among, and within, countries. No significant differences were observed by study quality, whereas comparing different periods within 2020 resulted in greater decrease (IRR: 0.61; CI: 0.53-0.71) than comparing 2020 vs. previous years (IRR: 0.74; CI 0.69-0.79). Among many variables, major predictors of heterogeneity were severe acute respiratory syndrome coronavirus 2 reproduction rate/country, number of hospitals queried, and reference period length; country stringency index and socio-economical indicators did not contribute significantly. CONCLUSIONS During the COVID-19 pandemic, NSTACS hospitalizations decreased significantly worldwide. However, substantial heterogeneity emerged among countries, and within the same country. Factors linked to public health management, but also to methodologies to collect results may have contributed to this heterogeneity. TRIAL REGISTRATION The protocol was registered in the PROSPERO International Prospective Register of Systematic Reviews (ID: CRD42022308159).
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Affiliation(s)
- Francesco Sofi
- Department of Experimental and Clinical Medicine, University of Florence, Florence 50134, Italy
| | - Monica Dinu
- Department of Experimental and Clinical Medicine, University of Florence, Florence 50134, Italy
| | - GianPaolo Reboldi
- Department of Medicine, University of Perugia School of Medicine, Perugia 06126, Italy
- Center for Clinical and Translational Research—CERICLET, University of Perugia School of Medicine, Perugia 06126, Italy
| | - Sofia Lotti
- Department of Experimental and Clinical Medicine, University of Florence, Florence 50134, Italy
| | - Luca Genovese
- Department of Cardiology, IRCCS MultiMedica, Milan 20138, Italy
| | - Isabella Tritto
- Division of Cardiology, University of Perugia School of Medicine, Perugia 06126, Italy
| | | | | | - Giuseppe Ambrosio
- Center for Clinical and Translational Research—CERICLET, University of Perugia School of Medicine, Perugia 06126, Italy
- Division of Cardiology, University of Perugia School of Medicine, Perugia 06126, Italy
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8
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Nechita L, Niculet E, Baroiu L, Balta AAS, Nechita A, Voinescu DC, Manole C, Busila C, Debita M, Tatu AL. Acute Myocardial Infarction in COVID-19 Patients-A Review of Literature Data and Two-Case Report Series. J Clin Med 2024; 13:2936. [PMID: 38792477 PMCID: PMC11121956 DOI: 10.3390/jcm13102936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 05/12/2024] [Accepted: 05/15/2024] [Indexed: 05/26/2024] Open
Abstract
Background/Objectives: The newly emergent COVID-19 pandemic involved primarily the respiratory system and had also major cardiovascular system (CVS) implications, revealed by acute myocardial infarction (AMI), arrhythmias, myocardial injury, and thromboembolism. CVS involvement is done through main mechanisms-direct and indirect heart muscle injury, with high mortality rates, worse short-term outcomes, and severe complications. AMI is the echo of myocardial injury (revealed by increases in CK, CK-MB, and troponin serum markers-which are taken into consideration as possible COVID-19 risk stratification markers). When studying myocardial injury, physicians can make use of imaging studies, such as cardiac MRI, transthoracic (or transesophageal) echocardiography, coronary angiography, cardiac computed tomography, and nuclear imaging (which have been used in cases where angiography was not possible), or even endomyocardial biopsy (which is not always available or feasible). Two-case-series presentations: We present the cases of two COVID-19 positive male patients who were admitted into the Clinical Department of Cardiology in "Sfântul Apostol Andrei" Emergency Clinical Hospital of Galați (Romania), who presented with acute cardiac distress symptoms and have been diagnosed with ST elevation AMI. The patients were 82 and 57 years old, respectively, with moderate and severe forms of COVID-19, and were diagnosed with anteroseptal left ventricular AMI and extensive anterior transmural left ventricular AMI (with ventricular fibrillation at presentation), respectively. The first patient was a non-smoker and non-drinker with no associated comorbidities, and was later discharged, while the second one died due to AMI complications. Conclusions: From this two-case series, we extract the following: old age alone is not a significant risk factor for adverse outcomes in COVID-19-related CVS events, and that the cumulative effects of several patient-associated risk factors (be it either for severe forms of COVID-19 and/or acute cardiac injury) will most probably lead to poor patient prognosis (death). At the same time, serum cardiac enzymes, dynamic ECG changes, along with newly developed echocardiographic modifications are indicators for poor prognosis in acute cardiac injury in COVID-19 patients with acute myocardial injury, regardless of the presence of right ventricular dysfunction (due to pulmonary hypertension).
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Affiliation(s)
- Luiza Nechita
- Doctoral School of Biomedical Sciences, ‘Dunarea de Jos’ University, 800008 Galati, Romania; (L.N.); (A.A.S.B.)
| | - Elena Niculet
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, “Dunărea de Jos” University, 800008 Galați, Romania
- ‘Sf. Apostol Andrei’ Clinical Emergency County Hospital, 800578 Galati, Romania; (D.C.V.); (C.M.)
| | - Liliana Baroiu
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania; (L.B.); (A.N.); (C.B.); (M.D.); (A.L.T.)
- ‘Sf. Cuv. Parascheva’ Clinical Hospital of Infectious Diseases, 800179 Galati, Romania
| | | | - Aurel Nechita
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania; (L.B.); (A.N.); (C.B.); (M.D.); (A.L.T.)
- ‘Sf. Ioan’ Clinical Hospital for Children, 800487 Galati, Romania
| | - Doina Carina Voinescu
- ‘Sf. Apostol Andrei’ Clinical Emergency County Hospital, 800578 Galati, Romania; (D.C.V.); (C.M.)
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania; (L.B.); (A.N.); (C.B.); (M.D.); (A.L.T.)
| | - Corina Manole
- ‘Sf. Apostol Andrei’ Clinical Emergency County Hospital, 800578 Galati, Romania; (D.C.V.); (C.M.)
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania; (L.B.); (A.N.); (C.B.); (M.D.); (A.L.T.)
| | - Camelia Busila
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania; (L.B.); (A.N.); (C.B.); (M.D.); (A.L.T.)
- ‘Sf. Ioan’ Clinical Hospital for Children, 800487 Galati, Romania
| | - Mihaela Debita
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania; (L.B.); (A.N.); (C.B.); (M.D.); (A.L.T.)
- ‘Sf. Cuv. Parascheva’ Clinical Hospital of Infectious Diseases, 800179 Galati, Romania
| | - Alin Laurentiu Tatu
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania; (L.B.); (A.N.); (C.B.); (M.D.); (A.L.T.)
- ‘Sf. Cuv. Parascheva’ Clinical Hospital of Infectious Diseases, 800179 Galati, Romania
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Aleksova A, Janjusevic M, Zhou XNO, Zandonà L, Chicco A, Stenner E, Beltrami AP, D'Errico S, Sinagra G, Marketou M, Fluca AL, Zwas DR. Persistence of vitamin D deficiency among Italian patients with acute myocardial infarction. Nutr Metab Cardiovasc Dis 2024; 34:1283-1294. [PMID: 38494368 DOI: 10.1016/j.numecd.2024.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 01/18/2024] [Accepted: 02/16/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND AND AIMS Vitamin D deficiency is a common cardiovascular risk factor associated with the development of atherosclerosis. We evaluated changes in 25(OH)D concentrations in 1510 patients with acute myocardial infarction (AMI) over a long observation period, including the COVID-19 pandemic. METHODS AND RESULTS Patients were separated into four groups according to the year of enrolment, group 1 (2009-2010), group 2 (2014-2016), group 3 (2017-2019), and group 4 (2020-2022). The median 25(OH)D concentration in the overall cohort was 17.15 (10.3-24.7) ng/mL. The median plasma concentrations of 25(OH)D for groups 1, 2, 3, and 4 were 14.45 (7.73-22.58) ng/mL, 17.3 ng/mL (10.33-24.2), 18.95 (11.6-26.73) ng/mL and 19.05 (12.5-27.3) ng/mL, respectively. Although 25(OH)D levels increased over the years, the prevalence of vitamin D deficiency remained high in each group (68.4%, 61.4%, 53.8%, and 52% respectively). Hypovitaminosis D was predicted by the season influence (OR:2.03, p < 0.0001), higher body mass index (OR:1.25; p = 0.001), diabetes mellitus (OR:1.54; p = 0.001), smoking (OR:1.47; p = 0.001), older age (OR:1.07; p = 0.008), higher triglycerides levels (OR:1.02; p = 0.01), and female gender (OR:1.3; p = 0.038). After multivariable adjustment, vitamin D ≤ 20 ng/mL was an independent predictor of mortality. CONCLUSION Vitamin D deficiency is highly prevalent and persistent in patients with AMI despite a trend towards increasing 25(OH)D concentrations over the years. The frequent lockdowns did not reduce the levels of 25(OH)D in the fourth group. Low levels of 25(OH)D are an independent predictor of mortality.
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Affiliation(s)
- Aneta Aleksova
- Azienda Sanitaria Universitaria Giuliano Isontina, Cardiothoracovascular Department, Trieste, Italy; Department of Medical Surgical and Health Sciences, University of Trieste, Trieste, Italy.
| | - Milijana Janjusevic
- Azienda Sanitaria Universitaria Giuliano Isontina, Cardiothoracovascular Department, Trieste, Italy; Department of Medical Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Xin Ning Oriana Zhou
- Department of Medical Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Lorenzo Zandonà
- SC Laboratorio Unico, Ospedale Maggiore, ASUGI, 34125 Trieste, Italy
| | - Andrea Chicco
- SC Laboratorio Unico, Ospedale Maggiore, ASUGI, 34125 Trieste, Italy
| | - Elisabetta Stenner
- Department of Diagnostics, Azienda USL Toscana Nordovest, 57100 Livorno, Italy
| | | | - Stefano D'Errico
- Department of Medical Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Gianfranco Sinagra
- Azienda Sanitaria Universitaria Giuliano Isontina, Cardiothoracovascular Department, Trieste, Italy; Department of Medical Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Maria Marketou
- Heraklion University General Hospital, University of Crete, School of Medicine, Cardiology Department Crete, Greece
| | - Alessandra Lucia Fluca
- Azienda Sanitaria Universitaria Giuliano Isontina, Cardiothoracovascular Department, Trieste, Italy; Department of Medical Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Donna R Zwas
- Linda Joy Pollin Cardiovascular Wellness Center for Women, Heart Institute, Hadassah University Medical Center, Jerusalem, Israel
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10
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Ekberg S, Molin D, Pahnke S, Bergström F, Brånvall E, Smedby KE, Wästerlid T. Impact of the COVID-19 pandemic on lymphoma incidence and short-term survival - a Swedish Lymphoma Register Study. Acta Oncol 2024; 63:164-168. [PMID: 38591352 PMCID: PMC11332491 DOI: 10.2340/1651-226x.2024.35238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 03/02/2024] [Indexed: 04/10/2024]
Abstract
BACKGROUND & PURPOSE The COVID-19 pandemic posed a large challenge for healthcare systems across the world. Comprehensive data on the impact of the COVID-19 pandemic on incidence and mortality in lymphoma are lacking. PATIENTS/METHODS Using data from the Swedish lymphoma register, we compare incidence and 1-year survival of lymphoma patients in Sweden before (2017-2019) and during the pandemic (2020 and 2021). RESULTS Fewer patients were diagnosed with lymphomas during March-June 2020, but the annual incidence rates for 2020 and 2021 were similar to those of 2017-2019. A larger proportion of patients presented with stage IV disease during 2021. There were no differences in other base-line characteristics nor application of active treatment in pre-pandemic and pandemic years. One-year overall survival was not inferior among lymphoma patients during the pandemic years compared to pre-pandemic years i.e., 2017-2019. INTERPRETATION The COVID-19 pandemic had limited impact on the incidence and mortality of lymphoma in Sweden.
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Affiliation(s)
- Sara Ekberg
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Daniel Molin
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden; cDepartment of Cancer Immunotherapy, Uppsala University, Uppsala, Sweden
| | - Simon Pahnke
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden; cDepartment of Cancer Immunotherapy, Uppsala University, Uppsala, Sweden
| | - Fanny Bergström
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Elsa Brånvall
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Department of Medicine, Capio St Göran Hospital, Stockholm, Sweden
| | - Karin E Smedby
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Department of Hematology, Karolinska University Hospital, Stockholm, Sweden
| | - Tove Wästerlid
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Department of Hematology, Karolinska University Hospital, Stockholm, Sweden.
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11
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Dhaliwal JS, Sekhon MS, Rajotia A, Dang AK, Singh PP, Bilal M, Sakthivel H, Ahmed R, Verma R, Ramphul K, Sethi PS. Disparities and Outcomes in the First and Second Year of the Pandemic on Events of Acute Myocardial Infarction in Coronavirus Disease 2019 Patients. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:597. [PMID: 38674243 PMCID: PMC11052327 DOI: 10.3390/medicina60040597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Revised: 03/29/2024] [Accepted: 04/02/2024] [Indexed: 04/28/2024]
Abstract
Background and Objectives: Coronavirus disease 2019 (COVID-19) caused several cardiovascular complications, including acute myocardial infarction (AMI), in infected patients. This study aims to understand the overall trends of AMI among COVID-19 patients during the first two years of the pandemic and the disparities and outcomes between the first and second years. Materials and Methods: The retrospective analysis was conducted via the 2020 and 2021 National Inpatient Sample (NIS) database for hospitalizations between April 2020 and December 2021 being analyzed for adults with a primary diagnosis of COVID-19 who experienced events of AMI. A comparison of month-to-month events of AMI and mortality of AMI patients with concomitant COVID-19 was made alongside their respective patient characteristics. Results: Out of 2,541,992 COVID-19 hospitalized patients, 3.55% experienced AMI. The highest rate of AMI was in December 2021 (4.35%). No statistical differences in trends of AMI mortality were noted over the 21 months. AMI cases in 2021 had higher odds of undergoing PCI (aOR 1.627, p < 0.01). They experienced higher risks of acute kidney injury (aOR 1.078, p < 0.01), acute ischemic stroke (aOR 1.215, p < 0.01), cardiac arrest (aOR 1.106, p < 0.01), need for mechanical ventilation (aOR 1.133, p < 0.01), and all-cause mortality (aOR 1.032, 95% CI 1.001-1.064, p = 0.043). Conclusions: The incidence of AMI among COVID-19 patients fluctuated over the 21 months of this study, with a peak in December 2021. COVID-19 patients reporting AMI in 2021 experienced higher overall odds of multiple complications, which could relate to the exhaustive burden of the pandemic in 2021 on healthcare, the changing impact of the virus variants, and the hesitancy of infected patients to seek care.
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Affiliation(s)
- Jasninder Singh Dhaliwal
- Department of Internal Medicine, University of California Riverside School of Medicine, Riverside, CA 92521, USA
| | - Manraj S. Sekhon
- Department of Internal Medicine, University of California Riverside School of Medicine, Riverside, CA 92521, USA
| | - Arush Rajotia
- Department of Internal Medicine, University of California Riverside School of Medicine, Riverside, CA 92521, USA
| | - Ashujot K. Dang
- Department of Internal Medicine, University of California Riverside School of Medicine, Riverside, CA 92521, USA
| | - Prabh Partap Singh
- School of Medicine, University of California Riverside School of Medicine, Riverside, CA 92521, USA
| | - Maham Bilal
- Department of Internal Medicine, Dow University of Health Sciences, Karachi 74200, Pakistan
| | - Hemamalini Sakthivel
- One Brooklyn Health System/Interfaith Medical Ctr Program, Brooklyn, NY 11213, USA
| | - Raheel Ahmed
- Royal Brompton Hospital, Part of Guy’s and St. Thomas’ NHS Foundation Trust, London SW3 6NP, UK
| | - Renuka Verma
- Department of Internal Medicine, Kirk Kerkorian School of Medicine at UNLV, Las Vegas, NV 89154, USA
| | | | - Prabhdeep S. Sethi
- Department of Internal Medicine, University of California Riverside School of Medicine, Riverside, CA 92521, USA
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12
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Mohr K, Hobohm L, Kaier K, Farmakis IT, Valerio L, Barco S, Abele C, Münzel T, Neusius T, Konstantinides S, Binder H, Keller K. Drivers and recent trends of hospitalisation costs related to acute pulmonary embolism. Clin Res Cardiol 2024:10.1007/s00392-024-02437-y. [PMID: 38565711 DOI: 10.1007/s00392-024-02437-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 03/11/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND AND AIMS The socio-economic burden imposed by acute pulmonary embolism (PE) on European healthcare systems is largely unknown. We sought to determine temporal trends and identify cost drivers of hospitalisation for PE in Germany. METHODS AND RESULTS We analysed the totality of reimbursed hospitalisation costs in Germany (G-DRG system) in the years 2016-2020. Overall, 484 884 PE hospitalisations were coded in this period. Direct hospital costs amounted to a median of 3572 (IQR, 2804 to 5869) euros, resulting in average total reimbursements of 710 million euros annually. Age, PE severity, comorbidities and in-hospital (particularly bleeding) complications were identified by multivariable logistic regression as significant cost drivers. Use of catheter-directed therapy (CDT) constantly increased (annual change in the absolute proportion of hospitalisations with CDT + 0.40% [95% CI + 0.32% to + 0.47%]; P < 0.001), and it more than doubled in the group of patients with severe PE (28% of the entire population) over time. Although CDT use was overall associated with increased hospitalisation costs, this association was no longer present (adjusted OR 1.02 [0.80-1.31]) in patients with severe PE and shock; this was related, at least in part, to a reduction in the median length of hospital stay (for 14.0 to 8.0 days). CONCLUSIONS We identified current and emerging cost drivers of hospitalisation for PE, focusing on severe disease and intermediate/high risk of an adverse early outcome. The present study may inform reimbursement decisions by policymakers and help to guide future health economic analysis of advanced treatment options for patients with PE.
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Affiliation(s)
- Katharina Mohr
- Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Lukas Hobohm
- Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Klaus Kaier
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Ioannis T Farmakis
- Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Luca Valerio
- Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Stefano Barco
- Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Department of Angiology, University Hospital Zurich, Zurich, Switzerland
| | - Christina Abele
- Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Thomas Münzel
- Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine Main, Mainz, Germany
| | - Thomas Neusius
- Wiesbaden Business School, RheinMain University of Applied Sciences, Wiesbaden, Germany
| | - Stavros Konstantinides
- Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.
- Department of Cardiology, Democritus University of Thrace, Alexandroupolis, Greece.
| | - Harald Binder
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Karsten Keller
- Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Medical Clinic VII, Department of Sports Medicine, University Hospital Heidelberg, Heidelberg, Germany
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13
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Razzaque MS. Can adverse cardiac events of the COVID-19 vaccine exacerbate preexisting diseases? Expert Rev Anti Infect Ther 2024; 22:131-137. [PMID: 38284355 DOI: 10.1080/14787210.2024.2311837] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 01/25/2024] [Indexed: 01/30/2024]
Abstract
INTRODUCTION SARS-CoV-2 infection and COVID-19 vaccination can both lead to serious cardiac conditions such as myocarditis, arrhythmia, acute myocardial infarction, and coagulopathy. Further studies are needed to better understand the risks and benefits of COVID-19 vaccination, and to determine the best course of action for individuals with preexisting heart conditions. AREAS COVERED The current knowledge and challenges in understanding vaccine-associated heart issues concerning the COVID-19 pandemic are briefly summarized, highlighting similar cardiac conditions caused by either SARS-CoV-2 infection or COVID-19 vaccination and the potential clinical impacts. EXPERT OPINION The short-term risks of severe cardiovascular side effects following COVID-19 vaccination are relatively low. However, further studies are needed to determine whether adverse vaccination events outweigh the long-term benefits in specific groups of individuals. Since cardiac inflammation, blood pressure dysregulation, coagulopathy, acute myocardial infarction, or arrhythmia could be the consequences of either SARS-CoV-2 infection or COVID-19 vaccination, clinical questions should be asked whether the COVID-19 vaccine worsens the condition in persons with preexisting heart diseases. It is important to carefully assess the potential risks and benefits of COVID-19 vaccination, especially for individuals with preexisting heart conditions, and to continue monitoring and studying the long-term effects of vaccination on cardiovascular health.
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Affiliation(s)
- Mohammed S Razzaque
- Professor of Pathology, Lake Erie College of Osteopathic Medicine, Erie, PA, USA
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14
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Choi HK, Maity M, Qureshi M, Haider A, Kapadia S, Fuerte S, Antony S, Razzaq W, Akbar A. Multifaceted Impact of the Coronavirus Disease 2019 (COVID-19) Pandemic on ST-Elevation Myocardial Infarction (STEMI): A Literature Review of Incidence, Treatment Modalities, and Outcomes. Cureus 2024; 16:e57288. [PMID: 38690470 PMCID: PMC11059148 DOI: 10.7759/cureus.57288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2024] [Indexed: 05/02/2024] Open
Abstract
The global repercussions of coronavirus disease 2019 (COVID-19) include substantial worldwide mortality and have brought to light existing gaps in healthcare systems. Particularly, diseases requiring time-sensitive treatment, such as ST-elevation myocardial infarction (STEMI), have faced significant challenges due to the impact and revelations of the COVID-19 pandemic on healthcare infrastructure. This review addresses the impact of the pandemic on STEMI, exploring incidence, treatment modalities, and clinical outcomes. Through a critical examination of existing literature, the intricate relationship between the pandemic and cardiovascular health, specifically STEMI, is elucidated. The COVID-19 pandemic has had a significant impact on the management of STEMI, with changes in hospitalization rates, treatment strategies, and the presentation of the disease posing significant challenges. The contradictory results of COVID-19 and post-vaccine myocardial infarction, as well as gender differences in reported cases, highlight the need for further research to clarify these relationships.
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Affiliation(s)
- Hoi K Choi
- Internal Medicine, University of Michigan, Ann Arbor, USA
| | - Madhurima Maity
- Internal Medicine, Sir H. N. Reliance Foundation Hospital and Research Centre, Mumbai, IND
| | - Mohammed Qureshi
- Internal Medicine, American University of the Caribbean School of Medicine, Cupecoy, SXM
| | - Ali Haider
- Medicine, Quetta Institute of Medical Sciences, Quetta, PAK
| | | | - Sofia Fuerte
- Internal Medicine, Instituto Tecnológico y de Estudios Superiores de Monterrey, Monterrey, MEX
| | - Simon Antony
- Internal Medicine, Sri Ramachandra Institute of Higher Education and Research, Chennai, IND
| | | | - Anum Akbar
- Pediatrics, University of Nebraska Medical Center, Omaha, USA
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15
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Rus M, Ardelean AI, Andronie-Cioara FL, Filimon GC. Acute Myocardial Infarction during the COVID-19 Pandemic: Long-Term Outcomes and Prognosis-A Systematic Review. Life (Basel) 2024; 14:202. [PMID: 38398712 PMCID: PMC10890474 DOI: 10.3390/life14020202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 01/13/2024] [Accepted: 01/24/2024] [Indexed: 02/25/2024] Open
Abstract
Coronavirus disease 2019 (COVID-19) was a global pandemic with high mortality and morbidity that led to an increased health burden all over the world. Although the virus mostly affects the pulmonary tract, cardiovascular implications are often observed among COVID-19 patients and are predictive of poor outcomes. Increased values of myocardial biomarkers such as troponin I or NT-proBNP were proven to be risk factors for respiratory failure. Although the risk of acute coronary syndromes (ACSs) was greater in the acute phase of COVID-19, there were lower rates of hospitalization for ACSs, due to patients' hesitation in presenting at the hospital. Hospitalized ACSs patients with COVID-19 infection had a prolonged symptom-to-first-medical-contact time, and longer door-to-balloon time. The mechanisms of myocardial injury in COVID-19 patients are still not entirely clear; however, the most frequently implicated factors include the downregulation of ACE2 receptors, endothelial dysfunction, pro-coagulant status, and increased levels of pro-inflammatory cytokines. The aim of this paper is to evaluate the long-term outcomes and prognosis of COVID-19 survivors that presented an acute myocardial infarction, by reviewing existing data. The importance of the association between this infectious disease and myocardial infarction arises from the increased mortality of patients with SARS-CoV-2 infection and AMI (10-76%, compared with 4.6% for NSTEMI patients and 7% for STEMI patients without COVID-19). The literature review showed an increased risk of cardiovascular events in COVID-19 survivors compared with the general population, even after the acute phase of the disease, with poorer long-term outcomes.
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Affiliation(s)
- Marius Rus
- Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
- Department of Preclinical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania; (A.I.A.); (G.C.F.)
| | - Adriana Ioana Ardelean
- Department of Preclinical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania; (A.I.A.); (G.C.F.)
| | - Felicia Liana Andronie-Cioara
- Department of Preclinical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania; (A.I.A.); (G.C.F.)
- Department of Psycho Neuroscience and Recovery, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania
| | - Georgiana Carmen Filimon
- Department of Preclinical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania; (A.I.A.); (G.C.F.)
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Kounis NG, Gogos C, de Gregorio C, Hung MY, Kounis SN, Tsounis EP, Assimakopoulos SF, Pourmasumi S, Mplani V, Servos G, Dousdampanis P, Plotas P, Michalaki MA, Tsigkas G, Grammatikopoulos G, Velissaris D, Koniar I. "When," "Where," and "How" of SARS-CoV-2 Infection Affects the Human Cardiovascular System: A Narrative Review. Balkan Med J 2024; 41:7-22. [PMID: 38173173 PMCID: PMC10767774 DOI: 10.4274/balkanmedj.galenos.2023.2023-10-25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 11/26/2023] [Indexed: 01/05/2024] Open
Abstract
Coronavirus disease 2019 (COVID-19) is caused by the novel severe acute respiratory coronavirus-2 (SARS-CoV-2). Several explanations for the development of cardiovascular complications during and after acute COVID-19 infection have been hypothesized. The COVID-19 pandemic, caused by SARS-CoV-2, has emerged as one of the deadliest pandemics in modern history. The myocardial injury in COVID-19 patients has been associated with coronary spasm, microthrombi formation, plaque rupture, hypoxic injury, or cytokine storm, which have the same pathophysiology as the three clinical variants of Kounis syndrome. The angiotensin-converting enzyme 2 (ACE2), reninaldosterone system (RAAS), and kinin-kallikrein system are the main proposed mechanisms contributing to cardiovascular complications with the COVID-19 infection. ACE receptors can be found in the heart, blood vessels, endothelium, lungs, intestines, testes, neurons, and other human body parts. SARS-CoV-2 directly invades the endothelial cells with ACE2 receptors and constitutes the main pathway through which the virus enters the endothelial cells. This causes angiotensin II accumulation downregulation of the ACE2 receptors, resulting in prothrombotic effects, such as hemostatic imbalance via activation of the coagulation cascade, impaired fibrinolysis, thrombin generation, vasoconstriction, endothelial and platelet activation, and pro-inflammatory cytokine release. The KKS system typically causes vasodilation and regulates tissue repair, inflammation, cell proliferation, and platelet aggregation, but SARS-CoV-2 infection impairs such counterbalancing effects. This cascade results in cardiac arrhythmias, cardiac arrest, cardiomyopathy, cytokine storm, heart failure, ischemic myocardial injuries, microvascular disease, Kounis syndrome, prolonged COVID, myocardial fibrosis, myocarditis, new-onset hypertension, pericarditis, postural orthostatic tachycardia syndrome, pulmonary hypertension, stroke, Takotsubo syndrome, venous thromboembolism, and thrombocytopenia. In this narrative review, we describe and elucidate when, where, and how COVID-19 affects the human cardiovascular system in various parts of the human body that are vulnerable in every patient category, including children and athletes.
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Affiliation(s)
- Nicholas G. Kounis
- Department of Cardiology, University of Patras Medical School, Rio, Greece
| | - Christos Gogos
- Clinic of Cardiology, COVID-19 Unit, Papageorgiou General Hospital, Pavlos Melas, Greece
| | - Cesare de Gregorio
- Department of Clinical and Experimental Medicine, University of Messina Medical School, Messina, Italy
| | - Ming-Yow Hung
- Division of Cardiology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | | | - Efthymios P. Tsounis
- Division of Gastroenterology, Department of Internal Medicine, Medical School, University Hospital of Patras, Rio, Greece
| | - Stelios F. Assimakopoulos
- Department of Internal Medicine, Division of Infectious Diseases, University of Patras Medical School, Rio, Greece
| | - Soheila Pourmasumi
- Social Determinants of Health Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Virginia Mplani
- Intensive Care Unit, Patras University Hospital, Rio, Greece
| | - George Servos
- Pediatric Cardiology Unit, “P. & A. Kyriakou” Children’s Hospital, Athina, Greece
| | | | - Panagiotis Plotas
- Department of Cardiology, University of Patras Medical School, Rio, Greece
| | - Marina A. Michalaki
- Department of Internal Medicine, Division of Endocrinology, University of Patras, School of Health Sciences, Rio, Greece
| | - Grigorios Tsigkas
- Department of Cardiology, University of Patras Medical School, Rio, Greece
| | | | - Dimitrios Velissaris
- Department of Internal Medicine, University of Patras Medical School, Rio, Greece
| | - Ioanna Koniar
- Electrophysiology and Device Department, University Hospital of South Manchester NHS Foundation Trust, Manchester, United Kingdom
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17
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Udupa MC, Saha S, Natarajan S. Numerical simulation of the blood flow through a pre-stenotic aneurysm in coronary artery: effects of varying heart rate. Comput Methods Biomech Biomed Engin 2024; 27:459-477. [PMID: 38146852 DOI: 10.1080/10255842.2023.2297659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 12/08/2023] [Indexed: 12/27/2023]
Abstract
The left anterior descending artery (LAD) is a significant coronary artery and a facilitator of oxygenated blood to the heart muscles. Thus, any occurrence of an aneurysm in LAD requires immediate medical attention. It is often inclined toward fatality if coupled with a blockage due to stenosis. Given the high relevance of understanding such models, invasive techniques under all parametric circumstances are hard to achieve. So, a theoretical approach with a cost-effective intervention of mathematical modeling becomes essential. In our current work, we analyze the model with the numerical technique of a modified form of SIMPLE pressure-correction based algorithm and perform parametric studies for the flow field with degree of stenosis, degree of aneurysm, heart rate, and distance separating aneurysm and stenosis as parameters. The study reveals a direct proportionality relation between the number of recirculation zones and heart rate through instantaneous streamline plots. Alongside this, the demonstration of an increase in the risk of rupture of the aneurysm with a decrease in the distance between stenosis and aneurysm, using the physical parameters associated with blood flow, is another key finding. Further, we examine the effect of the flow field on heat transfer and the consequent temperature profiles.
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Affiliation(s)
- Mahesh C Udupa
- Department of Mathematics, SAS, VIT Vellore, Tamil Nadu, India
| | - Sunanda Saha
- Centre for Clean Environment, VIT Vellore, Tamil Nadu, India
| | - Sekarapandian Natarajan
- Department of Thermal and Energy, School of Mechanical Engineering, VIT Vellore, Tamil Nadu, India
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18
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Nanavaty D, Sinha R, Kaul D, Sanghvi A, Kumar V, Vachhani B, Singh S, Devarakonda P, Reddy S, Verghese D. Impact of COVID-19 on Acute Myocardial Infarction: A National Inpatient Sample Analysis. Curr Probl Cardiol 2024; 49:102030. [PMID: 37573898 DOI: 10.1016/j.cpcardiol.2023.102030] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 08/07/2023] [Indexed: 08/15/2023]
Abstract
COVID-19 has been associated with a higher incidence of acute myocardial infarction and related complications. We sought to assess the impact of COVID-19 diagnosis on hospitalizations with an index admission of AMI. The National inpatient sample 2020 was queried for hospitalizations with an index admission of AMI, further stratified for admissions with and without COVID-19. The 2 groups' mortality, procedure, and complication rates were compared using suitable statistical tests. Multivariate regression analysis was further performed to study the impact of COVID-19 on mortality as the primary outcome and length of stay and total hospital cost as secondary outcomes. A total of 555,540 admissions for AMI were identified, of which 5818 (1.04%) had concomitant COVID-19. Hospitalizations in the COVID-19 cohort of both groups had a lower procedure rate for coronary angiography. Thrombolysis use was higher in the STEMI patients with COVID-19. Most cardiac complications in AMI patients were higher when infected with SARS-CoV-2. Multivariate regression analysis revealed that COVID-19 led to higher odds of mortality and total length of stay in AMI hospitalizations. COVID-19 portends a worse prognosis in hospitalizations with AMI. These admissions have a significantly higher mortality rate and increased complications.
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Affiliation(s)
- Dhairya Nanavaty
- Department of Internal Medicine, The Brooklyn Hospital Center, NY.
| | - Rishav Sinha
- Department of Internal Medicine, The Brooklyn Hospital Center, NY
| | - Diksha Kaul
- Department of Internal Medicine, The Brooklyn Hospital Center, NY
| | - Ankushi Sanghvi
- Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA
| | - Vikash Kumar
- Department of Internal Medicine, The Brooklyn Hospital Center, NY
| | | | - Sohrab Singh
- Department of Cardiology, The Brooklyn Hospital Center, NY
| | | | - Sarath Reddy
- Department of Cardiology, The Brooklyn Hospital Center, NY
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19
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Pourasghari H, Kolivand P, Azari S, Saberian P, Behzadifar M, Omidi N, Salehbeigi S, Raei B, Rajaie S, Luigi Bragazzi N, Golpira R, Khorgami MR, Khani M, Montazerinamin S, Lotfi F, Tajdini M. Epidemiological, clinical, and economic burden of myocardial infarction patients in Iran during the COVID-19 pandemic. IJC HEART & VASCULATURE 2023; 49:101288. [PMID: 38020058 PMCID: PMC10652134 DOI: 10.1016/j.ijcha.2023.101288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 10/18/2023] [Accepted: 10/20/2023] [Indexed: 12/01/2023]
Abstract
Background To define changes in AMI case rates, patient demographics, cardiovascular comorbidities, treatment approaches, in-hospital outcomes, and the economic burden of COVID-19 during the pandemic. Methods We conducted a multicenter, observational survey with selected hospitals from three medical universities in Tehran city. A data collection tool consisting of three parts. The first part included socio-demographic information, and the second part included clinical information, major complications, and in-hospital mortality. Finally, the third part was related to the direct medical costs generated by AMI in COVID-19 and non-COVID-19 patients. The study cohort comprised 4,560 hospitalizations for AMI (2,935 for STEMI [64%] and 1,625 for NSTEMI [36%]). Results Of those hospitalized for AMI, 1,864 (76.6 %) and 1,659 (78 %) were male before the COVID-19 outbreak and during the COVID-19 era, respectively. The length of stay (LOS), was significantly lower during the COVID-19 pandemic era (4.27 ± 3.63 vs 5.24 ± 5.17, p = 0.00). Results showed that there were no significant differences in terms of patient risk factors across periods. A total of 2,126 AMIs were registered during the COVID-19 era, with a 12.65 % reduction (95 % CI 1.5-25.1) compared with the equivalent time in 2019 (P = 0.179). The risk of in-hospital mortality rate for AMI patients increased from 4.9 % in 2019 to 7.0 % in the COVID-19 era (OR = 1.42; 95 % CI 1.11-1.82; P = 0.004). Major complications were registered in 9.7 % of cases in 2020, which is higher than the rate of 6.6 % reported in 2019 (OR = 1.46, 95 % CI 1.11-1.82; P = 0.000). Total costs in hospitalized AMI-COVID patients averaged $188 more than in AMI patients (P = 0.020). Conclusion This cross-sectional study found important changes in AMI hospitalization rates, worse outcomes, and higher costs during the COVID-19 periods. Future studies are recommended to examine the long-term outcomes of hospitalized AMI patients during the COVID-19 era.
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Affiliation(s)
- Hamid Pourasghari
- Hospital Management Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Pirhossein Kolivand
- Department of Health Economics, Faculty of Medicine, Shahed University, Tehran, Iran
| | - Samad Azari
- Hospital Management Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Peyman Saberian
- Department of Anesthesiology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoud Behzadifar
- Social Determinants of Health Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Negar Omidi
- Tehran Heart Center, Cardiovascular Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahrzad Salehbeigi
- Tehran Heart Center, Cardiovascular Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Behzad Raei
- Razi Educational and Therapeutic Center, Tabriz University of Medical Science, Tabriz, Iran
| | - Soheila Rajaie
- Research Center for Emergency and Disaster Resilience, Red Crescent Society of the Islamic Republic of Iran, Tehran, Iran
| | - Nicola Luigi Bragazzi
- Hospital Management Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran
| | - Reza Golpira
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammd Rafie Khorgami
- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Khani
- Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sara Montazerinamin
- Tehran Heart Center, Cardiovascular Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farhad Lotfi
- National Center for Health Insurance Research, Tehran, Iran
| | - Masih Tajdini
- Tehran Heart Center, Cardiovascular Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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20
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Koskinas KC, Twerenbold R, Carballo D, Matter CM, Cook S, Heg D, Frenk A, Windecker S, Osswald S, Lüscher TF, Mach F. Effects of SARS-COV-2 infection on outcomes in patients hospitalized for acute cardiac conditions. A prospective, multicenter cohort study (Swiss Cardiovascular SARS-CoV-2 Consortium). Front Cardiovasc Med 2023; 10:1203427. [PMID: 37900573 PMCID: PMC10613056 DOI: 10.3389/fcvm.2023.1203427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Accepted: 09/28/2023] [Indexed: 10/31/2023] Open
Abstract
Background Although the severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) causing coronavirus disease 2019 (COVID-19) primarily affects the respiratory system, the disease entity has been associated with cardiovascular complications. This study sought to assess the effect of concomitant SARS-COV-2 infection on clinical outcomes of patients hospitalized primarily for acute cardiac conditions on cardiology wards in Switzerland. Methods In this prospective, observational study conducted in 5 Swiss cardiology centers during the COVID-19 pandemic, patients hospitalized due to acute cardiac conditions underwent a reverse-transcriptase polymerase chain reaction test at the time of admission and were categorized as SARS-COV-2 positive (cases) or negative (controls). Patients hospitalized on cardiology wards underwent treatment for the principal acute cardiac condition according to local practice. Clinical outcomes were recorded in-hospital, at 30 days, and after 1 year and compared between cases and controls. To adjust for imbalanced baseline characteristics, a subgroup of patients derived by propensity matching was analyzed. Results Between March 2020 and February 2022, 538 patients were enrolled including 122 cases and 416 controls. Mean age was 68.0 ± 14.7 years, and 75% were men. Compared with controls, SARS-COV-2-positive patients more commonly presented with acute heart failure (35% vs. 17%) or major arrhythmia (31% vs. 9%), but less commonly with acute coronary syndrome (26% vs. 53%) or severe aortic stenosis (4% vs. 18%). Mortality was significantly higher in cases vs. controls in-hospital (16% vs. 1%), at 30 days (19.0% vs. 2.2%), and at 1 year (28.7% vs. 7.6%: p < 0.001 for all); this was driven primarily (up to 30 days) and exclusively (at one-year follow-up) by higher non-cardiovascular mortality, and was accompanied by a greater incidence of worsening renal function in cases vs. controls. These findings were maintained in a propensity-matched subgroup of 186 patients (93 cases and 93 controls) with balanced clinical presentation and baseline characteristics. Conclusions In this observational study of patients hospitalized for acute cardiac conditions, SARS-COV-2 infection at index hospitalization was associated with markedly higher all-cause and non-cardiovascular mortality throughout one-year follow-up. These findings highlight the need for effective, multifaceted management of both cardiac and non-cardiac morbidities and prolonged surveillance in patients with acute cardiac conditions complicated by SARS-COV-2 infection.
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Affiliation(s)
| | - Raphael Twerenbold
- Department of Cardiology, Basel University Hospital, Basel, Switzerland
- University Center of Cardiovascular Science & Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- German Center for Cardiovascular Research (DZHK) Partner Site Hamburg–Kiel–Lübeck, Hamburg, Germany
| | - David Carballo
- Division of Cardiology, Geneva University Hospitals, Geneva, Switzerland
| | | | - Stephane Cook
- Department of Cardiology, Fribourg Canton Hospital, Fribourg, Switzerland
| | - Dik Heg
- CTU Bern, University of Bern, Bern, Switzerland
| | - Andre Frenk
- Department of Cardiology, Bern University Hospital Inselspital, Bern, Switzerland
| | - Stephan Windecker
- Department of Cardiology, Bern University Hospital Inselspital, Bern, Switzerland
| | - Stefan Osswald
- Department of Cardiology, Basel University Hospital, Basel, Switzerland
| | - Thomas F. Lüscher
- Department of Cardiology, Royal Brompton & Harefield Hospitals and National Heart and Lung Institute, Imperial College, London, United Kingdom
- Center for Molecular Cardiology, University of Zurich, Zurich, Switzerland
| | - Francois Mach
- Division of Cardiology, Geneva University Hospitals, Geneva, Switzerland
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21
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Lemke VG, Paiva MSS, Mariano GZ, Alves TS, Ferreira E, Nunes LA, Oliveira FRA, Cantarelli R, do Nascimento EM, de Oliveira GMM. Brazilian Registry of Interventional Cardiology during the COVID-19 Pandemic (RBCI-COVID19). Arq Bras Cardiol 2023; 120:e20220840. [PMID: 37672473 PMCID: PMC10519241 DOI: 10.36660/abc.20220840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 04/08/2023] [Accepted: 05/17/2023] [Indexed: 09/08/2023] Open
Abstract
BACKGROUND At the beginning of the COVID-19 pandemic, patients with myocardial infarction (MI) took longer to present to hospitals because of fear of contamination and health care access difficulties. OBJECTIVES To assess interventional cardiology procedures performed during the COVID-19 pandemic and its implications for MI approach. METHODS Prospective registry of 24 cardiac catheterization laboratories in Brazil, with adult patients undergoing interventional cardiology procedures between May 26 and November 30, 2020. The outcomes were cardiovascular (CV) and non-CV complications, death, and MI. Concomitant COVID-19 was confirmed using RT-PCR. Machine learning techniques were used with nonparametric Classification Trees models, and Simple Correspondence Analysis, with R statistical software package. Significance level adopted of 5%. RESULTS This study included 1282 patients, 435 of whom (33.9%) had MI as follows: ST-segment elevation MI (STEMI), 239 (54.9%); and non-ST-segment elevation MI (NSTEMI), 196 (45.1%). Of the 1282 patients, 29 had CV complications, 47 had non-CV complications, and 31 died. The diagnosis of COVID-19 was confirmed in 77 patients (6%), with 15.58% mortality and non-CV complications in 6.49%. Most patients had significant coronary artery disease (63%), and an intracoronary thrombus was more often found in the presence of STEMI (3.4%) and COVID-19 (4%). A door-to-table time longer than 12 hours in NSTEMI was associated with 30.8% of complications, 25% in COVID-19 patients. CONCLUSIONS All deaths were preceded by CV or non-CV complications. The presence of COVID-19 was associated with death and non-fatal complications of patients undergoing interventional cardiology procedures during the pandemic.
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Affiliation(s)
| | - Maria Sanali Souza Paiva
- Hospital Universitário Onofre LopesNatalRNBrasilHospital Universitário Onofre Lopes – HUOL, Natal, RN – Brasil
| | | | - Thales Siqueira Alves
- Hospital Universitário Pedro ErnestoRio de JaneiroRJBrasilHospital Universitário Pedro Ernesto, Rio de Janeiro, RJ – Brasil
| | - Esmeralci Ferreira
- Universidade do Estado do Rio de JaneiroRio de JaneiroRJBrasilUniversidade do Estado do Rio de Janeiro – Doenças do Tórax, Rio de Janeiro, RJ – Brasil
| | - Leonardo Avany Nunes
- Hospital São João BatistaCriciúmaSCBrasilHospital São João Batista, Criciúma, SC – Brasil
| | | | - Rodrigo Cantarelli
- Universidade do Estado do Rio de JaneiroRio de JaneitoRJBrasilUniversidade do Estado do Rio de Janeiro, Rio de Janeito, RJ – Brasil
| | - Emilia Matos do Nascimento
- Universidade do Estado do Rio de JaneiroRio de JaneitoRJBrasilUniversidade do Estado do Rio de Janeiro, Rio de Janeito, RJ – Brasil
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22
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Schmitt VH, Hobohm L, Sagoschen I, Sivanathan V, Hahad O, Espinola-Klein C, Münzel T, Keller K. Diabetes Mellitus and Its Association with Adverse In-Hospital Outcomes in Patients with COVID-19-A Nationwide Study. Viruses 2023; 15:1627. [PMID: 37631970 PMCID: PMC10457863 DOI: 10.3390/v15081627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 07/21/2023] [Accepted: 07/23/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Diabetes mellitus (DM) represents a relevant risk factor regarding morbidity and mortality worldwide. However, only limited data exist regarding the impact of DM on the clinical outcome of patients with COVID-19 infection. METHODS All hospitalized patients with confirmed COVID-19-infection (ICD-code U07.1) during the year 2020 in Germany were included in the present study. Patients were stratified regarding the co-prevalence of DM (ICD-codes E10-E14), and the impact of DM on in-hospital case fatality and in-hospital adverse events was analyzed. RESULTS Overall, 176,137 hospitalizations with confirmed COVID-19 infection were documented; of these, 45,232 (25.7%) patients had an additional diagnosis of DM. Diabetic patients with COVID-19 were more often of male sex and 7 years older (median 76.0 (IQR: 66.0-83.0) vs. 69.0 (52.0-81.0) years, p < 0.001). COVID-19 patients with DM demonstrated an aggravated comorbidity profile, as reflected by a higher Charlson comorbidity index (6.0 (IQR: 4.0-8.0) vs. 3.0 (1.0-5.0), p < 0.001). Risk for pneumonia (OR 1.38 (95% CI: 1.35-1.41), p < 0.001), acute respiratory distress syndrome (OR 1.53 (95% CI: 1.47-1.60), p < 0.001), and need for intensive care (21.3% vs. 13.3%, p < 0.001) were increased in DM patients. DM was an independent risk factor for acute kidney failure (OR 1.49 (95% CI: 1.44-1.53), p < 0.001), dialysis (OR 1.56 (95% CI: 1.47-1.66), p < 0.001), mechanical ventilation (OR: 1.49 (95% CI: 1.43-1.56), p < 0.001), extracorporeal membrane oxygenation (OR 1.44 (95% CI: 1.27-1.62), p < 0.001), major adverse cardiac and cerebrovascular events (OR: 1.24 (95% CI: 1.20-1.27), p < 0.001), and in-hospital mortality (OR: 1.26 (95% CI: 1.22-1.30), p < 0.001). CONCLUSIONS In patients with COVID-19-infection, DM is a relevant risk factor for adverse events, including mortality. The vulnerable patient group of diabetics with COVID-19 requires intense medical care and monitoring during hospitalization.
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Affiliation(s)
- Volker H. Schmitt
- Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany; (V.H.S.); (L.H.); (I.S.); (O.H.); (C.E.-K.); (T.M.)
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, 55131 Mainz, Germany
| | - Lukas Hobohm
- Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany; (V.H.S.); (L.H.); (I.S.); (O.H.); (C.E.-K.); (T.M.)
- Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
| | - Ingo Sagoschen
- Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany; (V.H.S.); (L.H.); (I.S.); (O.H.); (C.E.-K.); (T.M.)
| | - Visvakanth Sivanathan
- Department of Gastroenterology, University Medical Center Mainz of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany;
| | - Omar Hahad
- Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany; (V.H.S.); (L.H.); (I.S.); (O.H.); (C.E.-K.); (T.M.)
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, 55131 Mainz, Germany
| | - Christine Espinola-Klein
- Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany; (V.H.S.); (L.H.); (I.S.); (O.H.); (C.E.-K.); (T.M.)
- Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
| | - Thomas Münzel
- Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany; (V.H.S.); (L.H.); (I.S.); (O.H.); (C.E.-K.); (T.M.)
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, 55131 Mainz, Germany
| | - Karsten Keller
- Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany; (V.H.S.); (L.H.); (I.S.); (O.H.); (C.E.-K.); (T.M.)
- Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, 55131 Mainz, Germany
- Medical Clinic VII, Department of Sports Medicine, University Hospital Heidelberg, 69120 Heidelberg, Germany
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23
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Holby SN, Richardson TL, Laws JL, McLaren TA, Soslow JH, Baker MT, Dendy JM, Clark DE, Hughes SG. Multimodality Cardiac Imaging in COVID. Circ Res 2023; 132:1387-1404. [PMID: 37167354 PMCID: PMC10171309 DOI: 10.1161/circresaha.122.321882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Infection with SARS-CoV-2, the virus that causes COVID, is associated with numerous potential secondary complications. Global efforts have been dedicated to understanding the myriad potential cardiovascular sequelae which may occur during acute infection, convalescence, or recovery. Because patients often present with nonspecific symptoms and laboratory findings, cardiac imaging has emerged as an important tool for the discrimination of pulmonary and cardiovascular complications of this disease. The clinician investigating a potential COVID-related complication must account not only for the relative utility of various cardiac imaging modalities but also for the risk of infectious exposure to staff and other patients. Extraordinary clinical and scholarly efforts have brought the international medical community closer to a consensus on the appropriate indications for diagnostic cardiac imaging during this protracted pandemic. In this review, we summarize the existing literature and reference major societal guidelines to provide an overview of the indications and utility of echocardiography, nuclear imaging, cardiac computed tomography, and cardiac magnetic resonance imaging for the diagnosis of cardiovascular complications of COVID.
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Affiliation(s)
- S Neil Holby
- Cardiovascular Medicine Fellowship, Division of Cardiology, Department of Internal Medicine (S.N.H., T.L.R., J.L.L.), Vanderbilt University Medical Center
| | - Tadarro Lee Richardson
- Cardiovascular Medicine Fellowship, Division of Cardiology, Department of Internal Medicine (S.N.H., T.L.R., J.L.L.), Vanderbilt University Medical Center
| | - J Lukas Laws
- Cardiovascular Medicine Fellowship, Division of Cardiology, Department of Internal Medicine (S.N.H., T.L.R., J.L.L.), Vanderbilt University Medical Center
| | - Thomas A McLaren
- Division of Cardiology, Department of Internal Medicine, Department of Radiology & Radiological Sciences (T.A.M., S.G.H.), Vanderbilt University Medical Center
| | - Jonathan H Soslow
- Thomas P. Graham Jr Division of Pediatric Cardiology, Department of Pediatrics (J.H.S.), Vanderbilt University Medical Center
| | - Michael T Baker
- Division of Cardiology, Department of Internal Medicine (M.T.B., J.M.D.), Vanderbilt University Medical Center
| | - Jeffrey M Dendy
- Division of Cardiology, Department of Internal Medicine (M.T.B., J.M.D.), Vanderbilt University Medical Center
| | - Daniel E Clark
- Division of Cardiology, Department of Internal Medicine, Stanford University School of Medicine (D.E.C.)
| | - Sean G Hughes
- Division of Cardiology, Department of Internal Medicine, Department of Radiology & Radiological Sciences (T.A.M., S.G.H.), Vanderbilt University Medical Center
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24
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Xu SW, Ilyas I, Weng JP. Endothelial dysfunction in COVID-19: an overview of evidence, biomarkers, mechanisms and potential therapies. Acta Pharmacol Sin 2023; 44:695-709. [PMID: 36253560 PMCID: PMC9574180 DOI: 10.1038/s41401-022-00998-0] [Citation(s) in RCA: 185] [Impact Index Per Article: 92.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 09/11/2022] [Indexed: 12/15/2022]
Abstract
The fight against coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 infection is still raging. However, the pathophysiology of acute and post-acute manifestations of COVID-19 (long COVID-19) is understudied. Endothelial cells are sentinels lining the innermost layer of blood vessel that gatekeep micro- and macro-vascular health by sensing pathogen/danger signals and secreting vasoactive molecules. SARS-CoV-2 infection primarily affects the pulmonary system, but accumulating evidence suggests that it also affects the pan-vasculature in the extrapulmonary systems by directly (via virus infection) or indirectly (via cytokine storm), causing endothelial dysfunction (endotheliitis, endothelialitis and endotheliopathy) and multi-organ injury. Mounting evidence suggests that SARS-CoV-2 infection leads to multiple instances of endothelial dysfunction, including reduced nitric oxide (NO) bioavailability, oxidative stress, endothelial injury, glycocalyx/barrier disruption, hyperpermeability, inflammation/leukocyte adhesion, senescence, endothelial-to-mesenchymal transition (EndoMT), hypercoagulability, thrombosis and many others. Thus, COVID-19 is deemed as a (micro)vascular and endothelial disease. Of translational relevance, several candidate drugs which are endothelial protective have been shown to improve clinical manifestations of COVID-19 patients. The purpose of this review is to provide a latest summary of biomarkers associated with endothelial cell activation in COVID-19 and offer mechanistic insights into the molecular basis of endothelial activation/dysfunction in macro- and micro-vasculature of COVID-19 patients. We envisage further development of cellular models and suitable animal models mimicking endothelial dysfunction aspect of COVID-19 being able to accelerate the discovery of new drugs targeting endothelial dysfunction in pan-vasculature from COVID-19 patients.
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Affiliation(s)
- Suo-Wen Xu
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, 230001, China.
| | - Iqra Ilyas
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, 230001, China
| | - Jian-Ping Weng
- Department of Endocrinology, Institute of Endocrine and Metabolic Diseases, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, Clinical Research Hospital of Chinese Academy of Sciences (Hefei), University of Science and Technology of China, Hefei, 230001, China.
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25
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Liu Y, Zhou S, Wang L, Xu M, Huang X, Li Z, Hajdu A, Zhang L. Machine learning approach combined with causal relationship inferring unlocks the shared pathomechanism between COVID-19 and acute myocardial infarction. Front Microbiol 2023; 14:1153106. [PMID: 37065165 PMCID: PMC10090501 DOI: 10.3389/fmicb.2023.1153106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 02/27/2023] [Indexed: 04/03/2023] Open
Abstract
BackgroundIncreasing evidence suggests that people with Coronavirus Disease 2019 (COVID-19) have a much higher prevalence of Acute Myocardial Infarction (AMI) than the general population. However, the underlying mechanism is not yet comprehended. Therefore, our study aims to explore the potential secret behind this complication.Materials and methodsThe gene expression profiles of COVID-19 and AMI were acquired from the Gene Expression Omnibus (GEO) database. After identifying the differentially expressed genes (DEGs) shared by COVID-19 and AMI, we conducted a series of bioinformatics analytics to enhance our understanding of this issue.ResultsOverall, 61 common DEGs were filtered out, based on which we established a powerful diagnostic predictor through 20 mainstream machine-learning algorithms, by utilizing which we could estimate if there is any risk in a specific COVID-19 patient to develop AMI. Moreover, we explored their shared implications of immunology. Most remarkably, through the Bayesian network, we inferred the causal relationships of the essential biological processes through which the underlying mechanism of co-pathogenesis between COVID-19 and AMI was identified.ConclusionFor the first time, the approach of causal relationship inferring was applied to analyzing shared pathomechanism between two relevant diseases, COVID-19 and AMI. Our findings showcase a novel mechanistic insight into COVID-19 and AMI, which may benefit future preventive, personalized, and precision medicine.Graphical abstract
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Affiliation(s)
- Ying Liu
- Department of Cardiology, Sixth Medical Center, PLA General Hospital, Beijing, China
| | - Shujing Zhou
- Department of Data Science and Visualization, Faculty of Informatics, University of Debrecen, Debrecen, Hungary
- Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Longbin Wang
- Department of Clinical Veterinary Medicine, Huazhong Agricultural University, Wuhan, China
| | - Ming Xu
- Department of Clinical Veterinary Medicine, Huazhong Agricultural University, Wuhan, China
| | - Xufeng Huang
- Department of Data Science and Visualization, Faculty of Informatics, University of Debrecen, Debrecen, Hungary
- Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Zhengrui Li
- Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
- Shanghai Research Institute of Stomatology, Shanghai, China
| | - Andras Hajdu
- Department of Data Science and Visualization, Faculty of Informatics, University of Debrecen, Debrecen, Hungary
- *Correspondence: Andras Hajdu,
| | - Ling Zhang
- Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, Shanghai, China
- National Clinical Research Center for Oral Diseases, Shanghai, China
- Shanghai Key Laboratory of Stomatology, Shanghai, China
- Shanghai Research Institute of Stomatology, Shanghai, China
- Ling Zhang,
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Li R, Jin J, Liu E, Zhang J. A novel circulating biomarker lnc-MALAT1 for acute myocardial infarction: Its relationship with disease risk, features, cytokines, and major adverse cardiovascular events. J Clin Lab Anal 2022; 36:e24771. [PMID: 36378551 PMCID: PMC9757019 DOI: 10.1002/jcla.24771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 10/30/2022] [Accepted: 11/01/2022] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Long noncoding RNA MALAT1 (lnc-MALAT1) modulates atherosclerotic progression, myocardial ischemia injury, and systematic inflammation, which may be closely involved in acute myocardial infarction (AMI) pathogenesis. Thus, the current study intended to explore the relationship of lnc-MALAT1 to disease risk, features, cytokines, and prognostication in AMI patients. METHODS This multicenter study consecutively enrolled 160 newly diagnosed AMI patients and 50 controls (angina pectoris patients). Their peripheral blood mononuclear cells were obtained to measure lnc-MALAT1 by RT-qPCR. Serum cytokines in AMI patients were detected by ELISA. In addition, AMI patients were followed up for major adverse cardiovascular event (MACE) risk evaluation. RESULTS Lnc-MALAT1 was higher in AMI patients than in controls (median: 2.245 vs. 0.996, p = 0.004), and it also presented a good capacity for differentiating AMI patients from controls with an area under the curve of 0.823. Lnc-MALAT1 was positively related to C-reactive protein (p = 0.005), low-density lipoprotein cholesterol (p = 0.022), cardiac troponin I (p = 0.021), and infarct size (p = 0.007), but not other biochemical indexes in AMI patients. Meanwhile, lnc-MALAT1 was positively associated with tumor necrosis factor-alpha (p = 0.001), interleukin (IL)-6 (p = 0.031), IL-17A (p = 0.042), vascular cell adhesion molecule-1 (p = 0.004), and intercellular adhesion molecule-1 (p = 0.021) among AMI patients. Importantly, after categorization, lnc-MALAT1 high (vs. low) was related to an elevated MACE accumulation rate (p = 0.035); furthermore, a higher lnc-MALAT1 quartile showed a trend to be linked with an increased MACE accumulation rate (p = 0.092). CONCLUSION Lnc-MALAT1 may serve as a biomarker for AMI risk, infarct size, inflammation and prognosis, but further validation by large-scale studies is needed.
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Affiliation(s)
- Ruirui Li
- Department of Cardiovascular DiseaseCangzhou Central Hospital of Tianjin Medical UniversityTianjinChina
| | - Jin Jin
- Department of Cardiovascular DiseaseCangzhou People's HospitalCangzhouHebeiChina
| | - Enxiang Liu
- Department of Cardiovascular DiseaseCangzhou People's HospitalCangzhouHebeiChina
| | - Jun Zhang
- Department of Cardiovascular DiseaseCangzhou Central Hospital of Tianjin Medical UniversityTianjinChina
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Cacciapuoti F, Caso I, Crisci M, Minicucci F, Cacciapuoti F. An unexpected cause of chest pain, dyspnea and palpitations in a young patient during a post-COVID syndrome. Monaldi Arch Chest Dis 2022. [PMID: 36382808 DOI: 10.4081/monaldi.2022.2417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 11/03/2022] [Indexed: 11/16/2022] Open
Abstract
A 31-year-old male presented with sudden onset of chest pain and dyspnea after a COVID-19 infection. Initially labeled as a myopericarditis related to COVID-19, because of the young age and low risk profile, after a multiparametric evaluation was possible to diagnose and treat an unstable lesion on an intermediate branch of left coronary.
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Anghel L, Tudurachi BS, Leonte A, Sascău RA, Zota IM, Bazyani A, Tinică G, Stătescu C. The Challenge of High Coronary Thrombotic Events in Patients with ST-Segment Elevation Myocardial Infarction and COVID-19. J Clin Med 2022; 11:6542. [PMID: 36362770 PMCID: PMC9654578 DOI: 10.3390/jcm11216542] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 11/01/2022] [Accepted: 11/02/2022] [Indexed: 11/06/2022] Open
Abstract
The aim of this observational study was to describe the characteristics and outcomes of coronavirus disease 2019 (COVID-19)-positive patients with ST-segment elevation myocardial infarction (STEMI), with a special focus on factors associated with a high risk of coronary thrombosis and in-hospital mortality. Comparing the two groups of patients with STEMI separated according to the presence of SARS-CoV-2 infections, it was observed that COVID-19 patients were more likely to present with dyspnea (82.43% vs. 61.41%, p = 0.048) and cardiogenic shock (10.52% vs. 5.40%, p = 0.012). A longer total ischemia time was observed in COVID-19 patients, and they were twice as likely to undergo coronary angiography more than 12 hours after the onset of symptoms (19.29% vs. 10.13%, p = 0.024). In 10 of 57 COVID-19-positive patients, a primary PCI was not necessary, and only thromboaspiration was performed (17.54% vs. 2.70%, p < 0.001). Platelet level was inversely correlated (r = −0.512, p = 0.025) with a higher risk of coronary thrombosis without an atherosclerotic lesion. Using a cut-off value of 740 ng/ml, D-dimers predicted a higher risk of coronary thrombosis, with a sensitivity of 80% and a specificity of 66% (ROC area under the curve: 0.826, 95% CI: 0.716−0.935, p = 0.001). These are novel findings that raise the question of whether more aggressive antithrombotic therapy is necessary for selected COVID-19 and STEMI patients.
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Affiliation(s)
- Larisa Anghel
- Internal Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy, 700503 Iași, Romania
- Cardiology Department, Cardiovascular Diseases Institute “Prof. Dr. George I. M. Georgescu”, 700503 Iași, Romania
| | - Bogdan-Sorin Tudurachi
- Cardiology Department, Cardiovascular Diseases Institute “Prof. Dr. George I. M. Georgescu”, 700503 Iași, Romania
| | - Andreea Leonte
- Cardiology Department, Cardiovascular Diseases Institute “Prof. Dr. George I. M. Georgescu”, 700503 Iași, Romania
| | - Radu Andy Sascău
- Internal Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy, 700503 Iași, Romania
- Cardiology Department, Cardiovascular Diseases Institute “Prof. Dr. George I. M. Georgescu”, 700503 Iași, Romania
| | - Ioana Mădălina Zota
- Internal Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy, 700503 Iași, Romania
- Cardiology Department, Cardiovascular Diseases Institute “Prof. Dr. George I. M. Georgescu”, 700503 Iași, Romania
| | - Amin Bazyani
- Interventional Department, Cardiovascular Diseases Institute “Prof. Dr. George I. M. Georgescu”, 700503 Iași, Romania
| | - Grigore Tinică
- Internal Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy, 700503 Iași, Romania
- Cardiovascular Surgery Department, Cardiovascular Diseases Institute “Prof. Dr. George I. M. Georgescu”, 700503 Iași, Romania
| | - Cristian Stătescu
- Internal Medicine Department, “Grigore T. Popa” University of Medicine and Pharmacy, 700503 Iași, Romania
- Cardiology Department, Cardiovascular Diseases Institute “Prof. Dr. George I. M. Georgescu”, 700503 Iași, Romania
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Temporal Trends in Patients with Peripheral Artery Disease Influenced by COVID-19 Pandemic. J Clin Med 2022; 11:jcm11216433. [PMID: 36362660 PMCID: PMC9655378 DOI: 10.3390/jcm11216433] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2022] [Revised: 10/26/2022] [Accepted: 10/27/2022] [Indexed: 01/08/2023] Open
Abstract
Background: The COVID-19 pandemic influences the health care management of acute and chronic diseases. Data concerning the influence of the pandemic on hospitalizations of patients with peripheral artery disease (PAD) are sparse. Methods: We analysed all patients hospitalized due to PAD between 1 January 2019 and 31 December 2020 in Germany. Hospitalizations of PAD patients during the pre-pandemic year 2019 were compared to the pandemic year 2020. Results: Overall, 361,029 hospitalizations of PAD patients in the years 2019 and 2020 (55.4% aged ≥70 years; 36.6% females) were included in this study. In the pre-pandemic year of 2019, a total of 25,501 (13.2%) more hospitalizations due to PAD were detected compared to the COVID-19 pandemic year of 2020 (2019: 192,765 [53.4%] vs. 2020: 168,264 [46.6%], p = 0.065). Overall, in 610 (0.4%) of the hospitalization cases, a COVID-19 infection was diagnosed. Regarding interventional/surgical treatments, total numbers of peripheral endovascular intervention of the lower extremity decreased by 9.9% (83,845 vs. 75,519, p < 0.001), surgical peripheral artery revascularization of the lower extremity by 11.4% (32,447 vs. 28,754, p = 0.041) and amputations by 4.0% (20,612 vs. 19,784, p < 0.001) in 2020 compared to 2019. The case fatality rate (2.6% vs. 2.4%, p < 0.001), as well as MACCE rate (3.4% vs. 3.2%, p < 0.001), were slightly higher during the pandemic year 2020 compared to the pre-pandemic year 2019. Conclusions: The COVID-19 pandemic influenced the number of hospitalizations of PAD patients with a 13.2% reduction in hospital admissions and decreased total numbers of revascularization and amputation treatments.
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Axelerad A, Stuparu AZ, Muja LF, Docu Axelerad S, Petrov SG, Gogu AE, Jianu DC. Narrative Review of New Insight into the Influence of the COVID-19 Pandemic on Cardiovascular Care. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:1554. [PMID: 36363511 PMCID: PMC9694465 DOI: 10.3390/medicina58111554] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 10/21/2022] [Accepted: 10/26/2022] [Indexed: 09/10/2024]
Abstract
Background and Objectives: The purpose of this paper was to perform a literature review on the effects of the COVID-19 pandemic on cardiothoracic and vascular surgery care and departments. Materials and Methods: To conduct this evaluation, an electronic search of many databases was conducted, and the resulting papers were chosen and evaluated. Results: Firstly, we have addressed the impact of COVID-19 infection on the cardiovascular system from the pathophysiological and treatment points of view. Afterwards, we analyzed every cardiovascular disease that seemed to appear after a COVID-19 infection, emphasizing the treatment. In addition, we have analyzed the impact of the pandemic on the cardiothoracic and vascular departments in different countries and the transitions that appeared. Finally, we discussed the implications of the cardiothoracic and vascular specialists' and residents' work and studies on the pandemic. Conclusions: The global pandemic caused by SARS-CoV-2 compelled the vascular profession to review the treatment of certain vascular illnesses and find solutions to address the vascular consequences of COVID-19 infection. The collaboration between vascular surgeons, public health specialists, and epidemiologists must continue to investigate the impact of the pandemic and the response to the public health issue.
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Affiliation(s)
- Any Axelerad
- Department of Neurology, General Medicine Faculty, ‘Ovidius’ University, 900470 Constanta, Romania
- Department of Neurology, ‘Sf. Ap. Andrei’ County Clinical Emergency Hospital of Constanta, 900591 Constanta, Romania
| | - Alina Zorina Stuparu
- Department of Neurology, General Medicine Faculty, ‘Ovidius’ University, 900470 Constanta, Romania
- Department of Neurology, ‘Sf. Ap. Andrei’ County Clinical Emergency Hospital of Constanta, 900591 Constanta, Romania
| | - Lavinia Florenta Muja
- Department of Neurology, General Medicine Faculty, ‘Ovidius’ University, 900470 Constanta, Romania
- Department of Neurology, ‘Sf. Ap. Andrei’ County Clinical Emergency Hospital of Constanta, 900591 Constanta, Romania
| | | | - Silvia Georgeta Petrov
- Doctoral School of the Faculty of Psychology and Educational Sciences within the University of Bucharest, 050663 Bucharest, Romania
| | - Anca Elena Gogu
- Department of Neurology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania
- Centre for Cognitive Research in Neuropsychiatric Pathology (Neuropsy-Cog), Faculty of Medicine, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania
| | - Dragos Catalin Jianu
- Department of Neurology, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania
- Centre for Cognitive Research in Neuropsychiatric Pathology (Neuropsy-Cog), Faculty of Medicine, “Victor Babeș” University of Medicine and Pharmacy, 300041 Timișoara, Romania
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Khan Z, Patel N. Prolonged Use of Tirofiban Infusion Without Percutaneous Coronary Intervention To Achieve Optimal Results in a COVID-19 Positive Patient With Inferior ST Segment Elevated Myocardial Infarction (STEMI) Secondary to Thromboembolism: A Case Report. Cureus 2022; 14:e30287. [DOI: 10.7759/cureus.30287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2022] [Indexed: 11/07/2022] Open
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Oettinger V, Stachon P, Hilgendorf I, Heidenreich A, Zehender M, Westermann D, Kaier K, von Zur Mühlen C. COVID-19 pandemic affects STEMI numbers and in-hospital mortality: results of a nationwide analysis in Germany. Clin Res Cardiol 2022; 112:550-557. [PMID: 36198827 PMCID: PMC9534737 DOI: 10.1007/s00392-022-02102-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 09/06/2022] [Indexed: 11/25/2022]
Abstract
Background The COVID-19 pandemic led to extensive restrictions in Germany in 2020, including the postponement of elective interventions. We examined the impact on ST-elevation myocardial infarction (STEMI) as an acute and non-postponable disease. Methods Using German national records, all STEMI between 2017 and 2020 were identified. Using the number of STEMI cases between 2017 and 2019, we created a forecast for 2020 and compared it with the observed number of STEMI in 2020. Results From 2017 to 2020, 248,062 patients were treated for STEMI in Germany. Mean age was 65.21 years and 28.36% were female. When comparing forecasted and observed STEMI in 2020, a correlation can be seen: noticeable fewer STEMI were treated in those weeks respectively months with an increasing COVID-19 hospitalization rate (monthly percentage decrease in STEMI: March − 14.85%, April − 13.39%, November − 11.92%, December − 22.95%). At the same time, the crude in-hospital mortality after STEMI increased significantly at the peaks of the first and second waves (relative risk/RR of monthly in-hospital mortality: April RR = 1.11 [95% CI 1.02; 1.21], November RR = 1.13 [1.04; 1.24], December RR = 1.16 [1.06; 1.27]). Conclusion The COVID-19 pandemic led to a noticeable decrease in the number of STEMI interventions in Germany at the peaks of the first and second waves in 2020, corresponding to an increase in COVID-19 hospitalizations. At the same time, in-hospital mortality after STEMI increased significantly in these phases. Graphical abstract Impact of the COVID-19 pandemic on STEMI numbers and in-hospital mortality in Germany. Relative difference between forecasted and observed STEMI numbers (above figure), the relative risk of in-hospital mortality (middle figure) as well as number of new hospital admissions for COVID-19 per million inhabitants according to Roser et al.27 (bottom figure). ![]()
Supplementary Information The online version contains supplementary material available at 10.1007/s00392-022-02102-2.
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Affiliation(s)
- Vera Oettinger
- Department of Cardiology and Angiology, University Heart Center, Faculty of Medicine, Medical Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.
- Center for Big Data Analysis in Cardiology (CeBAC), Department of Cardiology and Angiology, University Heart Center, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany.
| | - Peter Stachon
- Department of Cardiology and Angiology, University Heart Center, Faculty of Medicine, Medical Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
- Center for Big Data Analysis in Cardiology (CeBAC), Department of Cardiology and Angiology, University Heart Center, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany
| | - Ingo Hilgendorf
- Department of Cardiology and Angiology, University Heart Center, Faculty of Medicine, Medical Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Adrian Heidenreich
- Department of Cardiology and Angiology, University Heart Center, Faculty of Medicine, Medical Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
- Center for Big Data Analysis in Cardiology (CeBAC), Department of Cardiology and Angiology, University Heart Center, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany
| | - Manfred Zehender
- Department of Cardiology and Angiology, University Heart Center, Faculty of Medicine, Medical Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
- Center for Big Data Analysis in Cardiology (CeBAC), Department of Cardiology and Angiology, University Heart Center, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany
| | - Dirk Westermann
- Department of Cardiology and Angiology, University Heart Center, Faculty of Medicine, Medical Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Klaus Kaier
- Center for Big Data Analysis in Cardiology (CeBAC), Department of Cardiology and Angiology, University Heart Center, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Constantin von Zur Mühlen
- Department of Cardiology and Angiology, University Heart Center, Faculty of Medicine, Medical Center, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
- Center for Big Data Analysis in Cardiology (CeBAC), Department of Cardiology and Angiology, University Heart Center, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany
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Griewing S, Gremke N, Kreutz J, Schieffer B, Timmermann L, Markus B. Chronological Development of Cardiovascular Disease in Times of COVID-19: A Retrospective Analysis of Hospitalized Diseases of the Circulatory System and COVID-19 Patients of a German University Hospital. J Cardiovasc Dev Dis 2022; 9:jcdd9100325. [PMID: 36286277 PMCID: PMC9604270 DOI: 10.3390/jcdd9100325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 09/17/2022] [Accepted: 09/22/2022] [Indexed: 11/16/2022] Open
Abstract
This study aims at examining the chronological development of hospitalized cardiovascular and COVID-19 patients and comparing the effects on related sub-disciplines and main diagnoses for pre-pandemic (2017–2019) and pandemic (2020–2021) years in the setting of a German university maximum care provider. Data were retrospectively retrieved from the hospital performance controlling system for patient collectives with main diagnosis of diseases of the circulatory system (nCirculatory) and COVID-19 secondary diagnosis (nCOVID-19). The cardiovascular patient collective (nCirculatory = 25,157) depicts a steady state in terms of relative yearly development of patient numbers (+0.4%, 2019–2020, +0.1%, 2020–2021). Chronological assessment points towards monthly decline during lockdowns and phases of high regional incidence of COVID-19 (i.e., 2019–2020: March −10.2%, April −12.4%, December −14.8%). Main diagnoses of congestive heart failure (+16.1% 2019/2020; +19.2% 2019/2021) and acute myocardial infarction show an increase in case numbers over the course of the whole pandemic (+15.4% 2019/2020; +9.4% 2019/2021). The results confirm negative effects on the cardiovascular care situation during the entire pandemic in the setting of a university maximum care provider. A general increase in cardiac disorders and a worrisome turn in case development of acute myocardial infarction emphasize the feared cardiovascular burden of COVID-19.
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Affiliation(s)
- Sebastian Griewing
- University Hospital Marburg, Philipps-University Marburg, 35043 Marburg, Hessen, Germany
- Institute for Health Care Management, General Business Administration, Philipps-University Marburg, Universitätsstraße 24, 35037 Marburg, Hessen, Germany
- Correspondence: ; Tel.: +49-172-6823779
| | - Niklas Gremke
- University Hospital Marburg, Philipps-University Marburg, 35043 Marburg, Hessen, Germany
| | - Julian Kreutz
- University Hospital Marburg, Philipps-University Marburg, 35043 Marburg, Hessen, Germany
| | - Bernhard Schieffer
- University Hospital Marburg, Philipps-University Marburg, 35043 Marburg, Hessen, Germany
| | - Lars Timmermann
- University Hospital Marburg, Philipps-University Marburg, 35043 Marburg, Hessen, Germany
| | - Birgit Markus
- University Hospital Marburg, Philipps-University Marburg, 35043 Marburg, Hessen, Germany
- Institute for Health Care Management, General Business Administration, Philipps-University Marburg, Universitätsstraße 24, 35037 Marburg, Hessen, Germany
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Kim SY, Lee JP, Shin WR, Oh IH, Ahn JY, Kim YH. Cardiac biomarkers and detection methods for myocardial infarction. Mol Cell Toxicol 2022; 18:443-455. [PMID: 36105117 PMCID: PMC9463516 DOI: 10.1007/s13273-022-00287-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2022] [Indexed: 12/14/2022]
Abstract
Background A significant heart attack known as a myocardial infarction (MI) occurs when the blood supply to the heart is suddenly interrupted, harming the heart muscles due to a lack of oxygen. The incidence of myocardial infarction is increasing worldwide. A relationship between COVID-19 and myocardial infarction due to the recent COVID-19 pandemic has also been revealed. Objective We propose a biomarker and a method that can be used for the diagnosis of myocardial infarction, and an aptamer-based approach. Results For the diagnosis of myocardial infarction, an algorithm-based diagnosis method was developed using electrocardiogram data. A diagnosis method through biomarker detection was then developed. Conclusion Myocardial infarction is a disease that is difficult to diagnose based on the aspect of a single factor. For this reason, it is necessary to use a combination of various methods to diagnose myocardial infarction quickly and accurately. In addition, new materials such as aptamers must be grafted and integrated into new ways. Purpose of Review The incidence of myocardial infarction is increasing worldwide, and some studies are being conducted on the association between COVID-19 and myocardial infarction. The key to properly treating myocardial infarction is early detection, thus we aim to do this by offering both tools and techniques as well as the most recent diagnostic techniques. Recent Findings Myocardial infarction is diagnosed using an electrocardiogram and echocardiogram, which utilize cardiac signals. It is required to identify biomarkers of myocardial infarction and use biomarker-based ELISA, SPR, gold nanoparticle, and aptamer technologies in order to correctly diagnose myocardial infarction.
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Affiliation(s)
- Sang Young Kim
- Department of Food Science and Biotechnology, Shin Ansan University, 135 Sinansandaehak-Ro, Danwon-Gu, Ansan, 15435 Republic of Korea
| | - Jin-Pyo Lee
- School of Biological Sciences, Chungbuk National University, 1 Chungdae-Ro, Seowon-Gu, Cheongju 28644 South Korea
| | - Woo-Ri Shin
- School of Biological Sciences, Chungbuk National University, 1 Chungdae-Ro, Seowon-Gu, Cheongju 28644 South Korea
| | - In-Hwan Oh
- School of Biological Sciences, Chungbuk National University, 1 Chungdae-Ro, Seowon-Gu, Cheongju 28644 South Korea
| | - Ji-Young Ahn
- School of Biological Sciences, Chungbuk National University, 1 Chungdae-Ro, Seowon-Gu, Cheongju 28644 South Korea
| | - Yang-Hoon Kim
- School of Biological Sciences, Chungbuk National University, 1 Chungdae-Ro, Seowon-Gu, Cheongju 28644 South Korea
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Badin D, Ortiz-Babilonia C, Harris A, Raad M, Oni JK. Early Postoperative Complications in Total Hip and Knee Arthroplasty Before and During the COVID-19 Pandemic: A Retrospective Analysis of 38,234 Patients. Arthroplast Today 2022; 18:24-30. [PMID: 36092773 PMCID: PMC9444499 DOI: 10.1016/j.artd.2022.08.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 06/24/2022] [Accepted: 08/28/2022] [Indexed: 11/17/2022] Open
Abstract
Background The outcomes of total joint arthroplasty during the coronavirus disease 2019 (COVID-19) pandemic are unknown. We sought to compare early postoperative complications in total hip arthroplasty (THA) and total knee arthroplasty (TKA) prior to and during the COVID-19 pandemic. Methods Patients in the American College of Surgeons National Surgical Quality Improvement Program database who had THA or TKA in the latter halves (July to December) of 2019 and 2020 were identified. Patients were divided into pre-COVID-19 (2019) and during-COVID-19 (2020) cohorts. Propensity score matching and logistic regression were used to detect correlations between operative period and outcomes. Statistical significance was set at α = 0.05. Results A total of 38,234 THA and 61,956 TKA patients were included. There was a significantly higher rate of outpatient procedures in 2020 than that in 2019 for both THA (41.68% vs 6.59%, P < .001) and TKA (41.68% vs 7.56%, P < .001). On matched analysis, surgery in 2020 had lower odds of hospital stay for >1 day (THA: odds ratio [OR] 0.889; P < .001) (TKA: OR 0.644; P < .001) and nonhome discharge (THA: 0.655; P < .001) (TKA: 0.497; P < .001). There was also increased odds of superficial surgical site infection in THA (OR 1.272; P = .040) and myocardial infarction in TKA patients (OR 1.488; P = .042) in 2020 compared to those in 2019. There was no difference in the 15 other outcomes assessed. Conclusions Total joint arthroplasty surgery remains safe despite the COVID-19 pandemic. A statistically significant increase was detected in superficial surgical site infection and myocardial infarction risk during 2020 compared to 2019; however, the clinical significance of this is questionable. A shift away from inpatient stay was also present, possibly reflecting efforts to minimize nosocomial exposure to COVID-19.
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Meta-Analysis of the Effects of Recombinant Human Brain Natriuretic Peptides on Left Ventricular Remodeling in Patients with Acute Myocardial Infarction. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:8916791. [PMID: 36035276 PMCID: PMC9410856 DOI: 10.1155/2022/8916791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 07/25/2022] [Indexed: 11/18/2022]
Abstract
Objective Systematic evaluation of the efficacy of natriuretic recombination in human brain on disease myocardial infarction, left ventricular heart failure, and the efficacy and safety of long-term left ventricular remodeling. Methods Computerized search of CNKI, Wanfang database, Wipro Chinese Technology Publications (VIP) numerical database, Chinese Biomedical Literature Database (CBM), Medline Cochrane Library, clinical Trail.Gov clinical collection, and other documents. Randomized controlled trials (RCT) of recombinant human brain natriuretic peptide in the treatment of acute myocardial infarction from inception to December 2021 were searched. Based on the Jadad scale, inclusion-exclusion data for diseases were collected and elaborated by meta by RevMan 5.3 simulation software. In a total of 23 randomized controlled trials, 2 024 cases were used as the basic data, the control group was routinely treated for 1 012 cases, and 1 012 cases in the experimental group were also treated with natriuretic peptide in the recombinant human brain on the previous basis. Results In terms of overall efficacy, the experimental group was better than the control group, statistically significant (OR = 4.30, 95% CI (3.26, 5.67), P < 0.000 01), left ventricular ejection fraction in the experimental group than the control group (OR = 1.58, 95% CI (1.27, 1.90), P < 0.000 01). In terms of a myocardial strain in the left ventricle, the experimental group was superior to the control group. The difference was significant (OR = −0.91, 95% CI (-1.50, -0.33), P = 0.002). In terms of the cardiac output volume, the experimental group was superior to the control group (OR = 1.24, 95% CI (0.55, 1.94), P = 0.0005). Regarding brain natriuretic peptide precursors, the experimental group was superior to the control group (OR = −4.37, 95% CI (-6.21, -3.25), P < 0.00001). In terms of the heart rate, the experimental group was superior to the control group. Measurement of differential significance is as follows: OR = −13.70, 95% CI (-14.95, -12.46), P < 0.00001. In terms of contraction, the experimental group was superior to the comparison group (OR = −12.38, 95% CI (-17.98, -6.79), P < 0.00001). The experimental group outperformed the control group (OR = −7.42, 95% CI (-8.53, -6.30), P < 0.00001). In terms of bad influence, the measurement is as follows: OR = 0.95, 95% CI (0.29, 3.16), P = 0.94. Conclusion In patients with acute myocardial infarction and left ventricular remodeling, if treated with a heavy treatment of the group of cerebral natriuretic peptide mode, it can increase clinical treatment, improve the cardiac effect, inhibit ventricular remodeling, improve blood pressure and heart rhythm, and have greater clinical treatment and safety.
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Profili F, Seghieri G, Francesconi P. Effect of diabetes on short-term mortality and incidence of first hospitalizations for cardiovascular events after recovery from SARS-CoV-2 infection. Diabetes Res Clin Pract 2022; 187:109872. [PMID: 35429573 PMCID: PMC9006403 DOI: 10.1016/j.diabres.2022.109872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 04/06/2022] [Accepted: 04/10/2022] [Indexed: 11/16/2022]
Abstract
AIM To evaluate the impact of diabetes and COVID-19 on all-cause-mortality and first hospitalizations for cardiovascular events (CVE): myocardial infarction or stroke, within six months after being tested positive and having recovered from SARS-CoV-2 infection. METHODS Resident population in Tuscany, Italy of age 45-94 yr without prior hospitalization for CVE, tested positive for SARS-CoV-2 by March 1st, 2020 and afterwards recovering from COVID-19 was compared with age, gender and diabetes matched controls without infection, for incidence rate ratio (IRR) of all-cause-deaths or first CVE at six months follow up. RESULTS 46,152 subjects of whom 4,597 with diabetes, tested positive and recovered from SARS-CoV-2 were compared with 1:1 age, gender and diabetes matched controls without infection. COVID-19 was associated with higher all-cause-mortality: IRR:1.92(95 %CI:1.63-2.25) while diabetes with increased risk of first CVE hospitalizations: IRR:2.24(2.18-4.25). Co-presence of COVID-19 and diabetes didn't add any additional excess risk. Being women and statins' use significantly reduced death risk. CONCLUSIONS After recovery from COVID-19, independently of diabetes, all-cause-mortality risk at six months was twofold increased, while risk of first CVE hospitalization remained unmodified. Diabetes, independently of prior COVID-19, resulted in higher six-months risk of first CVE not of death. Female gender and statins' use reduced both excess risks.
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Alqahtani MS, Abbas M, Alsabaani A, Alqarni A, Almohiy HM, Alsawqaee E, Alshahrani R, Alshahrani S. The Potential Impact of COVID-19 Virus on the Heart and the Circulatory System. Infect Drug Resist 2022; 15:1175-1189. [PMID: 35345472 PMCID: PMC8957310 DOI: 10.2147/idr.s351318] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 03/08/2022] [Indexed: 12/13/2022] Open
Abstract
Heart attacks, arrhythmias, and cardiomyopathy are all linked to the 2019 coronavirus disease (COVID-19), which has been identified as a risk factor for cardiovascular disease. Nothing can be held accountable in the current state of affairs. Undiagnosed chronic systolic heart failure (CSHF) develops when the heart’s second half of the cardiac cycle does not function properly. As a result, the heart’s blood pumping function is interrupted. Stress-induced cardiomyopathy may be caused by a variety of factors inside the body (SICM). Cytokine storm and microvascular dysfunction are among the issues. There is inflammation in the heart muscle, which may lead to stress-induced cardiomyopathy. A major part of our study is going to be devoted to understanding the effects of coronavirus on the cardiovascular system and blood vessels. A lot of time and effort has been put into figuring out the health effects of radiation exposure. The heart and circulatory system are shown to be affected by the coronavirus in this research. COVID-19 is shown to influence persons with heart disease, heart failure, arrhythmias, microvascular angiopathy, and cardiac damage in this study.
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Affiliation(s)
- Mohammed S Alqahtani
- Radiological Sciences Department, College of Applied Medical Sciences, King Khalid University, Abha, 61421, Saudi Arabia.,BioImaging Unit, Space Research Centre, Michael Atiyah Building, University of Leicester, Leicester, LE1 7RH, U.K
| | - Mohamed Abbas
- Electrical Engineering Department, College of Engineering, King Khalid University, Abha, 61421, Saudi Arabia.,Computers and Communications Department, College of Engineering, Delta University for Science and Technology, Gamasa, 35712, Egypt
| | - Abdullah Alsabaani
- Department of Family and Community Medicine, College of Medicine, King Khalid University, Abha, 61421, Saudi Arabia
| | - Amjad Alqarni
- Radiological Sciences Department, College of Applied Medical Sciences, King Khalid University, Abha, 61421, Saudi Arabia
| | - Hussain M Almohiy
- Radiological Sciences Department, College of Applied Medical Sciences, King Khalid University, Abha, 61421, Saudi Arabia
| | - Entisar Alsawqaee
- Radiological Sciences Department, College of Applied Medical Sciences, King Khalid University, Abha, 61421, Saudi Arabia
| | - Raghad Alshahrani
- Radiological Sciences Department, College of Applied Medical Sciences, King Khalid University, Abha, 61421, Saudi Arabia
| | - Shahd Alshahrani
- Radiological Sciences Department, College of Applied Medical Sciences, King Khalid University, Abha, 61421, Saudi Arabia
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