Targeted Blood Plasma Proteomics and Hemostasis Assessment of Post COVID-19 Patients with Acute Myocardial Infarction

Area of Science:

• Cardiovascular Medicine
• Infectious Diseases
• Hematology

Background:

• The molecular basis of cardiovascular complications post-SARS-CoV-2 infection is not fully understood.
• Acute myocardial infarction (AMI) is a known complication, but its association with prior COVID-19 requires further investigation.

Purpose of the Study:

• To investigate blood coagulation, platelet aggregation, and plasma proteomic profiles in COVID-19 convalescents with AMI.
• To compare these features between patients with AMI post-COVID, AMI without COVID-19, and healthy controls with or without COVID-19 history.

Main Methods:

• Rotational thromboelastometry, thrombodynamics, and impedance aggregometry were used to assess hemostasis.
• Plasma proteomics analysis was performed to identify differential protein expression.
• Participants were stratified based on anti-N IgG levels for SARS-CoV-2 infection.

Main Results:

• Both AMI groups exhibited increased clot growth rates, thrombus size/density, and elevated levels of complement, endothelium-modifying, acute-phase, and procoagulant proteins.
• AMI patients post-COVID showed reduced levels of inflammation and hemostasis-related proteins (e.g., LBP, C4b-BPα, C1 inhibitor, fibrinogen β, protein S) compared to AMI controls.
• A less pronounced increase in acute-phase and hemostatic markers was observed in AMI post-COVID patients, potentially due to persistent immune alterations.

Conclusions:

• COVID-19 convalescence is associated with distinct hemostatic and proteomic alterations in patients with AMI.
• These findings suggest that prolonged immune system dysregulation after COVID-19 may influence cardiovascular complication development.
• Further research is needed to elucidate the long-term cardiovascular sequelae of SARS-CoV-2 infection.