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Habib MB, Abdelghani MS, Elyas A, Ashour AA, Altermanini M, Imran S, Arabi AR. Acute thrombotic occlusion involving three coronary arteries. A unique association with COVID-19 pneumonia. Clin Case Rep 2023; 11:e7803. [PMID: 37593346 PMCID: PMC10427750 DOI: 10.1002/ccr3.7803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 05/12/2023] [Accepted: 07/09/2023] [Indexed: 08/19/2023] Open
Abstract
Key Clinical Message Respiratory viruses, particularly COVID-19, can be associated with severe cases of myocardial infarction (MI). Physicians should have a low threshold for MI in COVID-19 patients who present with persistent chest pain as MI in rapidly deteriorating cases can be missed. Prompt response includes both timely diagnosis and swift treatment. Abstract The coronavirus disease 2019 (COVID-19) is associated with coronary artery thrombosis. Many cases of single-vessel and few cases of two-vessel thrombosis were reported. Herein, we report a unique association in a middle-aged man diagnosed with COVID-19 and presented later with acute myocardial infarction causing cardiogenic shock. The patient was found to have three-vessel thrombosis.
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Affiliation(s)
- Mhd Baraa Habib
- Department of Internal MedicineHamad Medical CorporationDohaQatar
| | | | - Ahmed Elyas
- Cardiology Department, Heart HospitalHamad Medical CorporationDohaQatar
| | - Anas A. Ashour
- Department of Internal MedicineHamad Medical CorporationDohaQatar
| | | | - Shahid Imran
- Cardiology Department, Heart HospitalHamad Medical CorporationDohaQatar
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Hajikhani B, Safavi M, Bostanshirin N, Sameni F, Ghazi M, Yazdani S, Nasiri MJ, Khosravi-Dehaghi N, Noorisepehr N, Sayyari S, Dadashi M. COVID-19 and coronary artery disease; A systematic review and meta-analysis. New Microbes New Infect 2023; 53:101151. [PMID: 37275509 PMCID: PMC10205132 DOI: 10.1016/j.nmni.2023.101151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 05/09/2023] [Accepted: 05/09/2023] [Indexed: 06/07/2023] Open
Abstract
Background and aim Patients with underlying cardiovascular disorders such as coronary artery disease (CAD) are more prone to severe forms and multiple complications of COVID-19. The present systematic review and meta-analysis aimed to investigate the impact of CAD on patients with COVID-19. Methods Main electronic databases, including Medline (via PubMed), EMBASE, and Web of Science, were carefully searched and reviewed for original research articles published between 2019 and 2021. One hundred nine studies that address CAD in patients with COVID-19 were selected and analyzed. Results Following search and screening processes, 109 relevant publications were selected for analysis. The meta-analysis of prevalence studies indicated that the frequency of CAD among patients with COVID-19 was reported in 10 countries with an overall frequency of 12.4% [(95% CI) 11.1-13.8] among 20079 COVID-19 patients. According to case reports/case series studies, 50.9% of COVID-19 patients suffered from CAD. Fever was the most common symptom in these patients (47%); 36.5% also had hypertension. Conclusion The results obtained during the present study show that the simultaneous presence of COVID-19 and CAD, especially in men and elderly patients, can increase the risks and complications of both diseases. Therefore, careful examination of the condition of this group of patients for timely diagnosis and treatment is strongly recommended.
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Affiliation(s)
- Bahareh Hajikhani
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahshid Safavi
- Department of Microbiology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Nazila Bostanshirin
- Department of Microbiology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Fatemeh Sameni
- Department of Microbiology, Faculty of Medicine, Shahed University, Tehran, Iran
| | - Mona Ghazi
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shahrooz Yazdani
- Department of Cardiology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Mohammad Javad Nasiri
- Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nafiseh Khosravi-Dehaghi
- Department of Pharmacognosy, School of Pharmacy, Alborz University of Medical Sciences, Karaj, Iran
- Evidence-Based Phytotherapy and Complementary Medicine Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Negin Noorisepehr
- Department of Biotechnology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
| | - Saba Sayyari
- Neonatal Health Research Center, Research Institute for Children's Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Shahid Beheshti University of Medical Sciences, Imam Hussein Hospital, Tehran, Iran
| | - Masoud Dadashi
- Department of Microbiology, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
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Grave C, Gabet A, Empana JP, Puymirat E, Tuppin P, Danchin N, Olié V. Care management and 90-day post discharge mortality in patients hospitalized for myocardial infarction and COVID-19: A French nationwide observational study. Arch Cardiovasc Dis 2022; 115:37-47. [PMID: 34952827 PMCID: PMC8666304 DOI: 10.1016/j.acvd.2021.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 11/09/2021] [Accepted: 11/15/2021] [Indexed: 01/04/2023]
Abstract
BACKGROUND Concomitant or cured coronavirus disease 2019 (COVID-19) in patients with myocardial infarction (MI) may lead to difficulties in acute care management and impair prognosis. AIMS To describe and compare the characteristics, care management and 90-day post discharge outcomes of patients hospitalized for MI who did not have COVID-19 with those of patients with concomitant or previous hospital-diagnosed COVID-19. METHODS This population-based French study included all patients hospitalized for MI in France (30 December 2019 to 04 October 2020) from the French National Health Data System. Outcomes were described for each COVID-19 group and compared using adjusted logistic regression analysis. RESULTS Among 55,524 patients hospitalized for MI, 135 had previous hospital-diagnosed COVID-19 and 329 had concomitant COVID-19. Patients with previous hospital-diagnosed COVID-19 had more personal history of cardiovascular diseases than those without concomitant/previous confirmed COVID-19. In-hospital and 90-day post discharge mortality rates of patients with previous COVID-19 were 8.1% and 4.0%, respectively, compared with 3.5% and 3.0% in patients without concomitant/previous confirmed COVID-19 (odds ratio [OR]adjin-hospital 1.83, 95% confidence interval [CI] 0.97-3.46; ORadjpostdischarge 0.77, 95% CI 0.28-2.13). Patients with concomitant COVID-19 had more personal history of cardiovascular diseases, but also a poorer prognosis than their no concomitant/no previous confirmed COVID-19 counterparts; they presented excess cardiac complications during hospitalization (ORadj 1.62, 95% CI 1.29-2.04), in-hospital mortality (ORadj 3.31, 95% CI 2.32-4.72) and 90-day post discharge mortality (ORadj 2.09, 95% CI 1.24-3.51). CONCLUSIONS In-hospital and 90-day post discharge mortality of patients hospitalized for MI who had previous hospital-diagnosed COVID-19 did not seem to differ from those hospitalized for MI alone. Conversely, concomitant COVID-19 and MI carried a poorer prognosis extending beyond the hospital stay. Special attention should be given to patients with simultaneous COVID-19 and MI, in terms of acute care and secondary prevention.
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Affiliation(s)
- Clémence Grave
- Santé Publique France (French Public Health Agency), 94415 Saint-Maurice, France,Corresponding author. Santé Publique France (French Public Health Agency), 12, rue du Val d’Osne, 94415 Saint-Maurice cedex, France
| | - Amélie Gabet
- Santé Publique France (French Public Health Agency), 94415 Saint-Maurice, France
| | - Jean-Philippe Empana
- Inserm, UMR-S970, department of epidemiology, Paris Cardiovascular Research Centre, université Paris Descartes, 75015 Paris, France
| | - Etienne Puymirat
- Department of cardiology, hôpital Européen Georges-Pompidou, université Paris-Descartes, AP–HP, 75015 Paris, France
| | - Philippe Tuppin
- Caisse Nationale de l’Assurance Maladie (French National Health Insurance), 75020 Paris, France
| | - Nicolas Danchin
- Department of cardiology, hôpital Européen Georges-Pompidou, université Paris-Descartes, AP–HP, 75015 Paris, France
| | - Valérie Olié
- Santé Publique France (French Public Health Agency), 94415 Saint-Maurice, France
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Montero-Cabezas JM, Córdoba-Soriano JG, Díez-Delhoyo F, Abellán-Huerta J, Girgis H, Rama-Merchán JC, García-Blas S, van Rees JB, van Ramshorst J, Jurado-Román A. Angiographic and Clinical Profile of Patients With COVID-19 Referred for Coronary Angiography During SARS-CoV-2 Outbreak: Results From a Collaborative, European, Multicenter Registry. Angiology 2021; 73:112-119. [PMID: 34318686 DOI: 10.1177/00033197211028760] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Data regarding angiographic characteristics, clinical profile, and inhospital outcomes of patients with coronavirus disease 2019 (COVID-19) referred for coronary angiography (CAG) are scarce. This is an observational study analyzing confirmed patients with COVID-19 referred for CAG from 10 European centers. We included 57 patients (mean age: 66 ± 15 years, 82% male) , of whom 18% had previous myocardial infarction (MI) and 29% had renal insufficiency and chronic pulmonary disease. ST-segment elevation myocardial infarction (STEMI) was the most frequent indication for CAG (58%). Coronavirus disease 2019 was confirmed after CAG in 86% and classified as mild in 49%, with 21% fully asymptomatic. A culprit lesion was identified in 79% and high thrombus burden in 42%; 7% had stent thrombosis. At 40 days follow-up, 16 (28%) patients experienced a major adverse cardiovascular event (MACE): 12 deaths (92% noncardiac), 1 MI, 2 stent thrombosis, and 1 stroke. In an European multicenter registry, patients with confirmed COVID-19 infection referred for CAG during the first wave of the severe acute respiratory syndrome coronavirus 2 pandemic presented mostly with STEMI and were predominantly males with comorbidities. Severity of COVID-19 was in general noncritical and 21% were asymptomatic at the time of CAG. Culprit coronary lesions with high thrombus burden were frequently identified, with a rate of stent thrombosis of 7%. The incidence of MACE at 40 days was high (28%), mostly due to noncardiac death.
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Affiliation(s)
- J M Montero-Cabezas
- Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands
| | - J G Córdoba-Soriano
- Department of Cardiology, Complejo Hospitalario Universitario de Albacete, Albacete, Spain
| | - F Díez-Delhoyo
- Department of Cardiology, Instituto de Investigación Sanitaria Gregorio Marañón, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - J Abellán-Huerta
- Department of Cardiology, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain
| | - H Girgis
- Department of Cardiology, Jeroen Bosch Hospital. 's-Hertogenbosch, the Netherlands
| | | | - S García-Blas
- Department of Cardiology, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - J B van Rees
- Department of Cardiology, Rijnstate Hospital, Arnhem, the Netherlands
| | - J van Ramshorst
- Department of Cardiology, Noordwest Ziekenhuisgroep, Alkmaar, the Netherlands
| | - A Jurado-Román
- Department of Cardiology, Hospital Universitario La Paz, Madrid, Spain
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Wijeratne T, Gillard Crewther S, Sales C, Karimi L. COVID-19 Pathophysiology Predicts That Ischemic Stroke Occurrence Is an Expectation, Not an Exception-A Systematic Review. Front Neurol 2021; 11:607221. [PMID: 33584506 PMCID: PMC7876298 DOI: 10.3389/fneur.2020.607221] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 11/30/2020] [Indexed: 12/27/2022] Open
Abstract
Clinical reports of neurological manifestations associated with severe coronavirus disease 2019 (COVID-19), such as acute ischemic stroke (AIS), encephalopathy, seizures, headaches, acute necrotizing encephalitis, cerebral microbleeds, posterior reversible leukoencephalopathy syndrome, hemophagocytic lymphohistiocytosis, peripheral neuropathy, cranial nerve palsies, transverse myelitis, and demyelinating disorders, are increasing rapidly. However, there are comparatively few studies investigating the potential impact of immunological responses secondary to hypoxia, oxidative stress, and excessive platelet-induced aggregation on the brain. This scoping review has focused on the pathophysiological mechanisms associated with peripheral and consequential neural (central) inflammation leading to COVID-19-related ischemic strokes. It also highlights the common biological processes shared between AIS and COVID-19 infection and the importance of the recognition that severe respiratory dysfunction and neurological impairments associated with COVID and chronic inflammation [post-COVID-19 neurological syndrome (PCNS)] may significantly impact recovery and ability to benefit from neurorehabilitation. This study provides a comprehensive review of the pathobiology of COVID-19 and ischemic stroke. It also affirms that the immunological contribution to the pathophysiology of COVID-19 is predictive of the neurological sequelae particularly ischemic stroke, which makes it the expectation rather than the exception. This work is of fundamental significance to the neurorehabilitation community given the increasing number of COVID-related ischemic strokes, the current limited knowledge regarding the risk of reinfection, and recent reports of a PCNS. It further highlights the need for global collaboration and research into new pathobiology-based neurorehabilitation treatment strategies and more integrated evidence-based care.
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Affiliation(s)
- Tissa Wijeratne
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
- Department of Neurology, Western Health and University Melbourne, Australian Institute of Muscular Skeletal Sciences (AIMSS), Level Three, Western Health Centre for Research and Education (WHCRE), Sunshine Hospital, Melbourne, VIC, Australia
- Department of Medicine, Faculty of Medicine, University of Rajarata, Anuradhapura, Sri Lanka
| | - Sheila Gillard Crewther
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
- Department of Neurology, Western Health and University Melbourne, Australian Institute of Muscular Skeletal Sciences (AIMSS), Level Three, Western Health Centre for Research and Education (WHCRE), Sunshine Hospital, Melbourne, VIC, Australia
| | - Carmela Sales
- Department of Neurology, Western Health and University Melbourne, Australian Institute of Muscular Skeletal Sciences (AIMSS), Level Three, Western Health Centre for Research and Education (WHCRE), Sunshine Hospital, Melbourne, VIC, Australia
- Department of Medicine, Faculty of Medicine, University of Rajarata, Anuradhapura, Sri Lanka
| | - Leila Karimi
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
- Department of Neurology, Western Health and University Melbourne, Australian Institute of Muscular Skeletal Sciences (AIMSS), Level Three, Western Health Centre for Research and Education (WHCRE), Sunshine Hospital, Melbourne, VIC, Australia
- Faculty of Social and Political Sciences, Ivane Javakhishvili Tbilisi State University, Tbilisi, Georgia
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Kelham M, Choudry FA, Hamshere S, Beirne AM, Rathod KS, Baumbach A, Ahluwalia A, Mathur A, Jones DA. Therapeutic Implications of COVID-19 for the Interventional Cardiologist. J Cardiovasc Pharmacol Ther 2020; 26:203-216. [PMID: 33331160 DOI: 10.1177/1074248420982736] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Although COVID-19 is viewed primarily as a respiratory disease, cardiovascular risk factors and disease are prevalent among infected patients and are associated with worse outcomes. In addition, among multiple extra-pulmonary manifestations, there has been an increasing recognition of specific cardiovascular complications of COVID-19. Despite this, in the initial stages of the pandemic there was evidence of a reduction in patients presenting to acute cardiovascular services. In this masterclass review, with the aid of 2 exemplar cases, we will focus on the important therapeutic implications of COVID-19 for interventional cardiologists. We summarize the existing evidence base regarding the varied cardiovascular presentations seen in COVID-19 positive patients and the prognostic importance and potential mechanisms of acute myocardial injury in this setting. Importantly, through the use of a systematic review of the literature, we focus our discussion on the observed higher rates of coronary thrombus burden in patients with COVID-19 and acute coronary syndromes.
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Affiliation(s)
- Matthew Kelham
- Department of Cardiology, 560754Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom
| | - Fizzah A Choudry
- Department of Cardiology, 560754Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom.,Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, 4617Queen Mary University of London, London, United Kingdom
| | - Stephen Hamshere
- Department of Cardiology, 560754Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom
| | - Anne-Marie Beirne
- Department of Cardiology, 560754Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom.,Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, 4617Queen Mary University of London, London, United Kingdom
| | - Krishnaraj S Rathod
- Department of Cardiology, 560754Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom.,Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, 4617Queen Mary University of London, London, United Kingdom
| | - Andreas Baumbach
- Department of Cardiology, 560754Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom.,Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, 4617Queen Mary University of London, London, United Kingdom
| | - Amrita Ahluwalia
- Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, 4617Queen Mary University of London, London, United Kingdom
| | - Anthony Mathur
- Department of Cardiology, 560754Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom.,Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, 4617Queen Mary University of London, London, United Kingdom
| | - Daniel A Jones
- Department of Cardiology, 560754Barts Heart Centre, St Bartholomew's Hospital, London, United Kingdom.,Centre for Cardiovascular Medicine and Devices, William Harvey Research Institute, 4617Queen Mary University of London, London, United Kingdom
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Kermani-Alghoraishi M. A Review of Coronary Artery Thrombosis: A New Challenging Finding in COVID-19 Patients and ST-elevation Myocardial Infarction. Curr Probl Cardiol 2020; 46:100744. [PMID: 33218787 PMCID: PMC7605791 DOI: 10.1016/j.cpcardiol.2020.100744] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 09/30/2020] [Accepted: 10/04/2020] [Indexed: 12/15/2022]
Abstract
As the COVID-19 pandemic continues, more information on the nonrespiratory effects of the coronavirus is obtained. Cardiovascular complications, especially acute coronary syndromes, are rare. However, they prove to be effective factors in the mortality rate of COVID-19 subjects. Acute ST-elevation myocardial infarction with a special angiographic pattern in the form of extensive and multivessel thrombosis, regardless of atherosclerotic plaques, has posed a new therapeutic challenge. This has been associated with an increase in the incidence of stent thrombosis. Hypercoagulation, due to severe inflammation, is the main pathology of this phenomenon. Technically, percutaneous coronary intervention with aspiration thrombectomy and injectable antiplatelet are the mainstay of treatment for these patients. In addition, it is vital that appropriate antiplatelet and ischemia treatment after the intervention be taken into account.
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Affiliation(s)
- Mohammad Kermani-Alghoraishi
- Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
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