Single-center register of myocardial revascularization in patients with coronary artery disease and acute coronary syndrome in the context of COVID-19 pandemic

Aim. To assess the short- and long-term outcomes of myocardial revascularization (MR) in patients with coronary artery disease (CAD) and acute coronary syndrome (ACS) in the context of coronavirus disease 2019 (COVID-19) pandemic. Material and methods. In the period from April to August 2020, 550 patients with CAD and ACS were included in the register. Emergency percutaneous transluminal coronary angioplasty (n=499) and on-pump coronary artery bypass grafting (CABG) (n=51) were performed. The follow-up period lasted 6 months. The pattern of complications after MR and effects of COVID-19 were analyzed. Results. The studied cohort is represented by patients with CAD >65 years old. ST segment elevation ACS was detected in 23%, acute myocardial infarction - in 59, 1%, in other cases - unstable angina. During hospitalization after MR, atrial fibrillation prevailed among cardiovascular complications (4, 7%). During this period, 29 (5, 3%) patients was diagnosed with COVID-19. In the short-term period after MR, 3 (0, 5%) people died due to COVID-19 complications. In the long-term period after MR, 4 (0, 7%) cases of non-fatal stroke were registered, while repeated MR - in 7, 1%. The all-cause mortality rate was 1, 3% (n=7), of which 57, 1% of patients died due to COVID-19 complications. In the subgroup of patients who underwent CABG, the greatest number of in-hospital complications was noted, where exudative pleurisy, atrial fibrillation and anemia prevailed. Of the patients with COVID-19, pneumonia in the shortand long-term postoperative periods was recorded in 48, 3 and 61, 3%, respectively. Pneumonia is associated with respiratory failure, cardiac dysfunction, and anemia. The risk of COVID-19 pneumonia during the entire follow-up period was higher in patients with ACS who underwent CABG (odds ratio, 19, 4; confidence interval: 13, 3-26, 1; p<0, 001). The overall survival rate was 98, 7%. Conclusion. COVID-19 infection in patients with ACS after MR effects pattern of postoperative complications. The proportion of COVID-19 pneumonia in patients with ACS in hospital, short- and long-term postoperative periods after MR significantly exceeds that in the general population. The leading factor associated with COVID-19 pneumonia in patients with ACS is on-pump CABG.