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Кардиоваскулярная терапия и профилактика

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Острый коронарный синдром у пациентов с COVID-19

https://doi.org/10.15829/1728-8800-2021-2806

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Аннотация

Развитие острого коронарного синдрома (ОКС) обусловлено острым несоответствием потребности миокарда в кислороде и его доставкой. Данный механизм в большей мере связан с прогрессированием коронарного атеросклероза в сочетании с воспалительным ответом, гипоксемией, прокоагулянтным состоянием плазмы крови и тромбоцитов. Пациенты с новой коронавирусной инфекцией COVID-19 (COronaVIrus Disease 2019), отягощенные по сердечно-сосудистым заболеваниям и коморбидной патологии, представляют группу высокого риска развития ОКС.

Цель. Провести анализ опубликованной литературы, в которой отражены данные о развитии ОКС у пациентов с COVID-19, его патогенезе, особенностях клинического течения.

Материал и методы. Поиск литературных данных осуществлялся с помощью сервисов Google Scholar, PubMed, ScienceDirect и Cyberleninka. В анализ были включены данные клинических рекомендаций по ведению пациентов с COVID-19, данные клинических исследований, отчетов и систематических обзоров.

Результаты. В настоящем литературном обзоре обобщены и систематизированы данные, представленные в современных научных публикациях, освещены аспекты клинического течения и особенности патогенетических механизмов, лежащих в основе ОКС у больных с COVID-19.

Заключение. Патогенез COVID-19 неразрывно связан с распространенным цитопатическим действием SARS-CoV-2 (Severe Acute Respiratory Syndrome CoronaVirus 2, коронавирус 2, вызывающий тяжелый острый респираторный дистресс-синдром), генерацией патологического неконтролируемого иммунного ответа, который обуславливает системное воспаление, а также реализацией прокоагулянтной активации системы гемостаза. У пациентов с COVID-19, наряду с атеросклеротическим процессом, данные механизмы значительно повышают риск развития ОКС и могут ухудшать его течение на госпитальном этапе.

Об авторах

М. Г. Чащин
Первый Московский государственный медицинский университет имени И.М. Сеченова Минздрава России (Сеченовский Университет)
Россия

Чащин Михаил Георгиевич — врач-анестезиолог-реаниматолог.

Москва.

Тел.: +7 (977) 433-11-18



А. Ю. Горшков
Национальный медицинский исследовательский центр терапии и профилактической медицины Минздрава России
Россия

Горшков Александр Юрьевич — кандидат медицинских наук, научный сотрудник отдела фундаментальных аспектов ожирения.

Москва.



О. М. Драпкина
Национальный медицинский исследовательский центр терапии и профилактической медицины Минздрава России
Россия

Драпкина Оксана Михайловна — доктор медицинских наук, профессор, член-корреспондент РАН, директор.

Москва.



Список литературы

1. COVID-19 Map — Johns Hopkins Coronavirus Resource Center n.d. https://coronavirus.jhu.edu/map.html (accessed February 3, 2021).

2. Временные методические рекомендации профилактика, диагностика и лечение новой коронавирусной инфекции (COVID-19) Версия 10 (08.02.2021). https://static-0.minzdrav.gov.ru/system/attachments/attaches/000/054/804/original/%D0%92%D1%80%D0%B5%D0%BC%D0%B5%D0%BD%D0%BD%D1%8B%D0%B5_%D0%9C%D0%A0_COVID-19_%28v.10%29-08.02.2021-2.1_%28003%29.pdf

3. Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395:507-13. doi:10.1016/S0140-6736(20)30211-7.

4. Wang D, Hu B, Hu C, et al. Clinical Characteristics of 138 Hospitalized Patients with 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020;323:1061-9. doi:10.1001/jama.2020.1585.

5. Richardson S, Hirsch JS, Narasimhan M, et al. Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area. JAMA. 2020;323:2052. doi:10.1001/jama.2020.6775.

6. Braiteh N, Rehman W ur, Alom M, et al. Decrease in acute coronary syndrome presentations during the COVID-19 pandemic in upstate New York. Am Heart J. 2020;226:147-51. doi:10.1016/j.ahj.2020.05.009.

7. Metzler B, Siostrzonek P, Binder RK, et al. Decline of acute coronary syndrome admissions in Austria since the outbreak of COVID-19: the pandemic response causes cardiac collateral damage. Eur Heart J. 2020;41:1852-3. doi:10.1093/eurheartj/ehaa314.

8. Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497-506. doi:10.1016/S0140-6736(20)30183-5.

9. Guo YR, Cao QD, Hong ZS, et al. The origin, transmission and clinical therapies on coronavirus disease 2019 (COVID-19) outbreak- An update on the status. Mil Med Res. 2020;7(1):11. doi:10.1186/s40779-020-00240-0.

10. Uri K, Fagyas M, Kertesz A, et al. Circulating ACE2 activity correlates with cardiovascular disease development. J Renin Angiotensin Aldosterone Syst. 2016;17. doi:10.1177/1470320316668435.

11. Chen L, Li X, Chen M, et al. The ACE2 expression in human heart indicates new potential mechanism of heart injury among patients infected with SARS-CoV-2. Cardiovasc Res. 2020;116:1097-100. doi:10.1093/cvr/cvaa078.

12. Chen C, Yan JT, Zhou N, et al. Analysis of myocardial injury in patients with COVID-19 and association between concomitant cardiovascular diseases and severity of COVID-19. Zhonghua Xin Xue Guan Bing Za Zhi. 2020;48:567-71. doi:10.3760/cma.j.cn112148-20200225-00123.

13. Li C, Jiang J, Wang F, et al. Longitudinal correlation of biomarkers of cardiac injury, inflammation, and coagulation to outcome in hospitalized COVID-19 patients. J Mol Cell Cardiol. 2020;147:74-87. doi:10.1016/j.yjmcc.2020.08.008.

14. Cao J, Zheng Y, Luo Z, et al. Myocardial injury and COVID-19: Serum hs-cTnI level in risk stratification and the prediction of 30day fatality in COVID-19 patients with no prior cardiovascular disease. Theranostics. 2020;10:9663-73. doi:10.7150/thno.47980.

15. Li L, Zhou Q, Xu J. Changes of Laboratory Cardiac Markers and Mechanisms of Cardiac Injury in Coronavirus Disease 2019. Biomed Res Int. 2020;2020:7413673. doi:10.1155/2020/7413673.

16. Buja LM, Wolf D, Zhao B, et al. The emerging spectrum of cardiopulmonary pathology of the coronavirus disease 2019 (COVID-19): Report of 3 autopsies from Houston, Texas, and review of autopsy findings from other United States cities. Cardiovasc Pathol. 2020;48:107233. doi:10.1016/j.carpath.2020.107233.

17. Zhang J, Tecson KM, McCullough PA. Endothelial dysfunction contributes to COVID-19-associated vascular inflammation and coagulopathy. Rev Cardiovasc Med. 2020;21:315-9. doi:10.31083/j.rcm.2020.03.126.

18. Mehta P, McAuley DF, Brown M, et al. COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet. 2020;395:1033-4. doi:10.1016/S0140-6736(20)30628-0.

19. Henry BM, De Oliveira MHS, Benoit S, et al. Hematologic, biochemical and immune biomarker abnormalities associated with severe illness and mortality in coronavirus disease 2019 (COVID-19): A meta-analysis. Clin Chem Lab Med. 2020;58:1021-8. doi:10.1515/cclm-2020-0369.

20. Wang MT, Lin SC, Tang PL, et al. The impact of DPP-4 inhibitors on long-term survival among diabetic patients after first acute myocardial infarction. Cardiovasc Diabetol. 2017;16(1):89. doi:10.1186/s12933-017-0572-0.

21. Aghili N, Devaney JM, Alderman LO, et al. Polymorphisms in dipeptidyl peptidase IV gene are associated with the risk of myocardial infarction in patients with atherosclerosis. Neuropeptides. 2012;46:367-71. doi:10.1016/j.npep.2012.10.001.

22. Dai Y, Wang X, Ding Z, et al. DPP-4 inhibitors repress foam cell formation by inhibiting scavenger receptors through protein kinase C pathway. Acta Diabetol. 2014;51:471-8. doi:10.1007/s00592-013-0541-3.

23. Du H, Wang DW, Chen C. The potential effects of DPP-4 inhibitors on cardiovascular system in COVID-19 patients. J Cell Mol Med. 2020;24:10274-8. doi:10.1111/jcmm.15674.

24. Kaminski KA, Kozuch M, Bonda T, et al. Coronary sinus concentrations of interleukin 6 and its soluble receptors are affected by reperfusion and may portend complications in patients with myocardial infarction. Atherosclerosis. 2009;206:581-7. doi:10.1016/j.atherosclerosis.2009.03.033.

25. Anderson DR, Poterucha JT, Mikuls TR, et al. IL-6 and its receptors in coronary artery disease and acute myocardial infarction. Cytokine. 2013;62:395-400. doi:10.1016/j.cyto.2013.03.020.

26. Van Den Berg VJ, Umans VAWM, Brankovic M, et al. Stabilization patterns and variability of hs-CRP, NT-proBNP and ST2 during 1 year after acute coronary syndrome admission: Results of the BIOMArCS study. Clin Chem Lab Med. 2020;58:2099-106. doi:10.1515/cclm-2019-1320.

27. Zhao X, Liu C, Zhou P, et al. Estimation of Major Adverse Cardiovascular Events in Patients With Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention: A Risk Prediction Score Model From a Derivation and Validation Study. Front Cardiovasc Med. 2020;7. doi:10.3389/fcvm.2020.603621.

28. Reynoso-Villalpando GL, Padilla-Gutierrez JR, Valdez-Haro A, et al. Relationship between C-Reactive Protein Serum Concentration and the 1846 C>T (rs1205) Polymorphism in Patients with Acute Coronary Syndrome from Western Mexico. Genet Test Mol Biomarkers. 2017;21:334-40. doi:10.1089/gtmb.2016.0312.

29. Fontes JA, Rose NR, Cihakova D. The varying faces of IL-6: From cardiac protection to cardiac failure. Cytokine. 2015;74:62-8. doi:10.1016/j.cyto.2014.12.024.

30. Iba T, Levy JH, Connors JM, et al. The unique characteristics of COVID-19 coagulopathy. Crit Care. 2020;24:360. doi:10.1186/s13054-020-03077-0.

31. Lobastov K V, Schastlivtsev IV, Porembskaya OY, et al. COVID-19-associated coagulopathy: review of current recommendations for diagnosis, treatment and prevention. Hospital-Replacing Technol Surg. 2020;2020. doi:10.21518/1995-1477-2020-3-4.

32. Han M, Yan W, Huang Y, et al. The Nucleocapsid Protein of SARS-CoV Induces Transcription of hfgl2 Prothrombinase Gene Dependent on C/EBP Alpha. J Biochem. 2008;144:51-62. doi:10.1093/jb/mvn042.

33. Chen G, Wu D, Guo W, et al. Clinical and immunological features of severe and moderate coronavirus disease 2019. J Clin Invest. 2020;130:2620-9. doi:10.1172/JCI137244.

34. Zhang J-J, Dong X, Cao Y-Y, et al. Clinical characteristics of 140 patients infected with SARS-CoV-2 in Wuhan, China. Eur J Allergy Clin Immunol. 2020;75:1730-41. doi:10.1111/all.14238.

35. Hendren NS, Drazner MH, Bozkurt B, et al. Description and Proposed Management of the Acute COVID-19 Cardiovascular Syndrome. Circulation. 2020;141:1903-14. doi:10.1161/CIRCULATIONAHA.120.047349.

36. Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395:1054-62. doi:10.1016/S0140-6736(20)30566-3.

37. Wichmann D, Sperhake JP, Lutgehetmann M, et al. Autopsy Findings and Venous Thromboembolism in Patients With COVID-19: A Prospective Cohort Study. Ann Intern Med. 2020;173:268-77. doi:10.7326/M20-2003.

38. Corman VM, Landt O, Kaiser M, et al. Detection of 2019 novel coronavirus (2019-nCoV) by real-time RT-PCR. Euro Surveill. 2020;25(3):2000045. doi:10.2807/1560-7917.ES.2020.25.3.2000045.

39. Chughtai AA, Tan TC, Hitchen EM, et al. Association of influenza infection and vaccination with cardiac biomarkers and left ventricular ejection fraction in patients with acute myocardial infarction. IJC Heart Vasc. 2020;31:100648. doi:10.1016/j.ijcha.2020.100648.

40. Sharma Y, Horwood C, Chua A, et al. Prognostic impact of high sensitive troponin in predicting 30-day mortality among patients admitted to hospital with influenza. IJC Heart Vasc. 2021;32. doi:10.1016/j.ijcha.2020.100682.

41. Vejpongsa P, Kitkungvan D, Madjid M, et al. Outcomes of Acute Myocardial Infarction in Patients with Influenza and Other Viral Respiratory Infections. Am J Med. 2019;132:1173-81. doi:10.1016/j.amjmed.2019.05.002.

42. Mohammad MA, Tham J, Koul S, et al. Association of acute myocardial infarction with influenza: A nationwide observational study. PLoS One. 2020;15:e0236866. doi:10.1371/journal.pone.0236866.

43. Peiris JSM, Chu CM, Cheng VCC, et al. Clinical progression and viral load in a community outbreak of coronavirus-associated SARS pneumonia: A prospective study. Lancet. 2003;361:1767-72. doi:10.1016/S0140-6736(03)13412-5.

44. De Luca G, Cercek M, Jensen LO, et al. Impact of COVID-19 pandemic and diabetes on mechanical reperfusion in patients with STEMI: insights from the ISACS STEMI COVID 19 Registry. Cardiovasc Diabetol. 2020;19:1-13. doi:10.1186/s12933-020-01196-0.

45. Wu J, Mamas M, Rashid M, et al. Patient response, treatments, and mortality for acute myocardial infarction during the COVID-19 pandemic. Eur Hear J Qual Care Clin Outcomes. 2021;7(3):238-246. doi:10.1093/ehjqcco/qcaa062.

46. De Rosa S, Spaccarotella C, Basso C, et al. Reduction of hospitalizations for myocardial infarction in Italy in the COVID-19 era. Eur Heart J. 2020;41:2083-8. doi:10.1093/eurheartj/ehaa409.

47. Matsushita K, Hess S, Marchandot B, et al. Clinical features of patients with acute coronary syndrome during the COVID-19 pandemic. J Thromb Thrombolysis. 2020:1-10. doi:10.1007/s11239-020-02340-z.

48. Case BC, Yerasi C, Forrestal BJ, et al. Comparison of Characteristics and Outcomes of Patients With Acute Myocardial Infarction With Versus Without Coronarvirus-19. Am J Cardiol. 2020. doi:10.1016/j.amjcard.2020.12.059.

49. Choudry FA, Hamshere SM, Rathod KS, et al. High Thrombus Burden in Patients With COVID-19 Presenting With ST-Segment Elevation Myocardial Infarction. J Am Coll Cardiol. 2020;76:1168-76. doi:10.1016/j.jacc.2020.07.022.

50. Rodriguez-Leor O, Cid-Alvarez B, Ojeda S, et al. Impact of the COVID-19 pandemic on interventional cardiology activity in Spain. REC Interv Cardiol. 2020;2:82-9. doi:10.24875/RECICE.M20000123.

51. Secco GG, Tarantini G, Mazzarotto P, et al. Invasive strategy for COVID patients presenting with acute coronary syndrome: The first multicenter Italian experience. Catheter Cardiovasc Interv. 2020:ccd.28959. doi:10.1002/ccd.28959.

52. Ozaki Y, Katagiri Y, Onuma Y, et al. CVIT expert consensus document on primary percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) in 2018. Cardiovasc Interv Ther. 2018;33:178-203. doi:10.1007/s12928-018-0516-y.


Для цитирования:


Чащин М.Г., Горшков А.Ю., Драпкина О.М. Острый коронарный синдром у пациентов с COVID-19. Кардиоваскулярная терапия и профилактика. 2021;20(5):2806. https://doi.org/10.15829/1728-8800-2021-2806

For citation:


Chashchin M.G., Gorshkov A.Yu., Drapkina O.M. Acute coronary syndrome in COVID-19 patients. Cardiovascular Therapy and Prevention. 2021;20(5):2806. (In Russ.) https://doi.org/10.15829/1728-8800-2021-2806

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ISSN 1728-8800 (Print)
ISSN 2619-0125 (Online)