Impact of risk factors on intervened and non-intervened coronary lesions

Assessment of Risk Factors for Coronary Artery Restenosis and Patient Survival During the COVID-19 Pandemic

Background: In-stent restenosis of coronary arteries is a significant problem in interventional cardiology. Inflammatory processes in the arterial intima play a key role among the well-known risk factors for restenosis. The COVID-19 pandemic has contributed to the development of inflammation and the activation of the coagulation system. The aim of this study was to assess the risk factors for coronary artery restenosis and patient survival during the COVID-19 pandemic. Materials and Methods: We performed a cross-sectional study on a targeted sample of patients with coronary artery disease who underwent repeat myocardial revascularization (931 patients). The main study group, consisting of patients with coronary artery stent restenosis, included 420 patients (38.5% had previous COVID-19). The control group included 511 patients without stent restenosis (20.9% had COVID-19). Results: The results of multiple logistic regression analysis showed that the odds ratio (OR) for COVID-19 was 2.29 (95% CI 2.78-3.19) (p < 0.001), and the OR for C-reactive protein (CRP) was 1.08 (95% CI 1.002-1.013). The average hospital survival time for subjects with prior COVID-19 (N = 269) was 9.53 ± 0.106 days (95% CI 9.32-9.74), while for those without COVID-19 (N = 662), it was 9.89 ± 0.032 days (95% CI 9.83-9.96) (p < 0.001). The one-year survival time was 316.7 ± 6.982 days (95% CI 303.0-330.4) for the COVID-19 group and 340.14 ± 3.243 days (95% CI 333.8-346.5) for the non-COVID-19 group (p < 0.001). Conclusions: The main risk factors for in-stent restenosis were COVID-19 and elevated CRP levels. The average survival time in the group with prior COVID-19 was statistically significantly lower than in patients without COVID-19, both during the hospital stay and within one year after repeated revascularization.

Helicobacter pylori, Atherosclerosis, and Coronary Artery Disease: A Narrative Review

Coronary artery disease (CAD) is one of the leading causes of death worldwide, significantly contributing to mortality in both developed and developing nations. CAD arises from a combination of risk factors, including atherosclerosis, dyslipidemia, hypertension, diabetes, and smoking. In recent years, growing evidence has suggested a potential link between infectious agents and cardiovascular diseases. Among these, Helicobacter pylori (H. pylori) infection has been hypothesized for over a decade to play a role in the pathogenesis of CAD. This hypothesis is based on the bacterium's ability to trigger host inflammatory or autoimmune responses, potentially contributing to the progression of atherosclerotic plaques and coronary events. The association between H. pylori infection and CAD is of considerable interest as it opens new avenues for prevention and management strategies in cardiovascular health. Understanding this relationship could lead to innovative approaches to reducing the burden of CAD, particularly in populations with a high prevalence of H. pylori. In this review, we aim to provide a comprehensive overview of the most recent evidence on the involvement of H. pylori in the development and prognosis of CAD. By analyzing and synthesizing current findings, we seek to shed light on unresolved questions and clarify the ambiguous aspects of this potential connection. Our goal is to contribute to a deeper understanding of how H. pylori, may influence cardiovascular disease and to inspire further research in this critical area.