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Microvascular Dysfunction in COVID-19 Patients with Acute Coronary Syndrome

Erol Kalender1, Gunes Melike Dogan1, Kudret Keskin1

  • 1Department of Cardiology, University of Health Sciences Türkiye, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Türkiye.

Sisli Etfal Hastanesi Tip Bulteni
|October 30, 2023
PubMed

Insights

Coronavirus disease 2019 (COVID-19) impairs microvascular function in patients with acute coronary syndrome (ACS), indicated by slower coronary flow and reduced myocardial blush. This microvascular dysfunction is linked to higher mortality risk in COVID-19 patients with ACS.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Microvascular Function

Background:

  • Coronavirus disease 2019 (COVID-19) is hypothesized to worsen endothelial function via hyperinflammation.
  • Microvascular dysfunction is a potential consequence of COVID-19 infection.

Purpose of the Study:

  • To investigate microvascular dysfunction in COVID-19 patients experiencing acute coronary syndrome (ACS).
  • To assess angiographic parameters, specifically thrombolysis in myocardial infarction frame count (TFC) and myocardial blush grade (MBG), in this patient group.

Main Methods:

  • 165 patients with ACS undergoing percutaneous coronary intervention were analyzed.
  • Polymerase chain reaction testing was used to diagnose COVID-19 in patients with suggestive symptoms or CT findings.
  • Thrombolysis in myocardial infarction frame count (TFC) and myocardial blush grade (MBG) were the primary angiographic parameters evaluated.

Main Results:

  • 15.7% of ACS patients tested positive for COVID-19.
  • COVID-19 positive patients exhibited significantly higher TFC (slower flow) and lower MBG (impaired perfusion) (p<0.001).
  • Higher peak troponin-I levels (p=0.006) and increased in-hospital mortality (38.4% vs. 7.2%, p<0.001) were observed in the COVID-19 group.

Conclusions:

  • COVID-19 is associated with slow coronary flow and microvascular impairment in patients with ACS.
  • TFC and ejection fraction may serve as predictors of in-hospital mortality in COVID-19 patients with ACS.
Abstract

Keywords:
Acute myocardial infarctionCOVID-19Myocardial blush gradeThrombolysis in myocardial infarction flow gradeThrombolysis in myocardial infarction frame count

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