COVID-19-Related Pathologies in Coronary Angiography in Patients with Acute Coronary Syndromes

Background: The SARS-CoV-2 virus, identified in December 2019, led to a global pandemic resulting in over 6 million deaths. While most COVID-19 cases present mild symptoms, severe complications can develop in immunocompromised patients, including impacts on the heart. This study aimed to compare angiographic findings and hospitalization outcomes in acute coronary syndrome (ACS) patients with and without COVID-19. Methods: This retrospective study analyzed 174 ACS patients (105 men, 69 women) hospitalized in the Department of Cardiology and Internal Medicine of the Nicolaus Copernicus University in Bydgoszcz and Regional Hospital in Grudziądz (2019-2021). Forty-eight of them had COVID-19. The analyzed parameters included, inter alia, the coronary artery disease severity, the presence of thrombosis, survival rates, risk factors, and prior endovascular procedures. Results: COVID-19 patients with ACS showed a higher rate of thrombus in non-culprit vessels (6.25% vs. 0.0%, p = 0.0293), and overall survival was significantly lower (68.75% vs. 93.65%, p < 0.0001), while prior PCI rates were higher in non-COVID patients (34.13% vs. 6.25%, p = 0.0002). Procedure times were shorter for non-COVID patients, reducing catheterization lab exposure. Other procedural factors showed no significant differences. Conclusions: This study highlights significant differences in coronary angiography and hospitalization outcomes between ACS patients with and without COVID-19. The extended stay of COVID-19 patients in the catheterization lab poses an increased risk to medical staff, and the presence of thrombi underscores the need for effective antithrombotic strategies. The significant association of COVID-19 with hypercoagulability and its role in precipitating acute coronary syndromes necessitates the development of specific clinical guidelines to manage these patients effectively.