THE IMPACT OF COVID-19 INFECTION ON THE EFFICACY AND SAFETY OF REPERFUSION THERAPY IN ACUTE CORONARY SYNDROME WITH ST-SEGMENT ELEVATION: SHORT- AND LONG-TERM OUTCOMES
- Авторы:Khurshid G’ayratovich Fozilov, Baxtiyor Rajabboyevich Atamuratov
- Дата публикации:March 24, 2026
- Тип:Статья
- DOI: 10.64156/mju.9034 Скопировано
- Том / № Выпуска:Том 1 №2 (2026)
Аннотация
Abstract. The study evaluated the impact of prior COVID-19 infection on the efficacy and safety of reperfusion therapy in patients with ST-segment elevation acute coronary syndrome (STEMI). COVID-19 positive patients exhibited a significantly higher incidence of MACE, while primary percutaneous coronary intervention (pPCI) provided a better long-term prognosis compared to thrombolytic therapy (TLT).
Objective: To investigate the impact of prior COVID-19 infection on the efficacy and safety of reperfusion therapy (thrombolytic therapy - TLT and primary percutaneous coronary intervention — pPCI) in patients with ST-segment elevation acute coronary syndrome (STE-ACS), as well as to evaluate short- and long-term (24-month) clinical outcomes, particularly the development of major adverse cardiovascular events (MACE).
Materials and Methods. From 2021 to 2024, 200 patients were followed for 24 months at the Republican Specialized Cardiology Center. Patients were divided according to COVID-19 history: COVID-positive (n=75) and COVID-negative (n=125). Each group was further stratified by reperfusion therapy type (TLT or pPCI). Clinical, laboratory, echocardiographic, and angiographic parameters, as well as MACE incidence, were analyzed using statistical methods.
Conclusions. STEMI patients with prior COVID-19 had a significantly higher incidence of cardiovascular death, repeat ischemia-related revascularization, and MACE. pPCI was more effective than TLT, improving long-term prognosis. Prior COVID-19 represents an independent adverse prognostic factor in STEMI patients.
Keywords: COVID-19, STEMI, reperfusion therapy, thrombolysis, pPCI, MACE.
Annotatsiya. Tadqiqot o’tkir koronar sindrom ST-segmenti ko’tarilishi (O’KS-ST) bilan kasallangan bemorlarda avval o’tkazilgan COVID-19 infeksiyasining reperfuziya terapiyasi samaradorligi va xavfsizligiga ta’sirini baholadi. COVID-musbat bemorlarda MACE hodisalari chastotasi sezilarli darajada yuqori bo’ldi, bTOKA TLTga nisbatan uzoq muddatli prognozni yaxshiladi.
Materiallar va usullar. 2021-2024 yillarda Respublika ixtisoslashtirilgan kardiologiya markazida 200 bemor 24 oy davomida kuzatildi. Bemorlar COVID-19 anamnezi bo’yicha COVID-musbat (n=75) va COVID-manfiy (n=125) guruhlarga ajratildi. Har bir guruhda reperfuziya terapiyasi turiga (TLT yoki bTOKA) qarab kichik guruhlar tashkil qilindi. Klinik, laborator, exokardiyografik va angiografik ko’rsatkichlar hamda MACE chastotasi statistik usullar bilan tahlil qilindi.
Xulosa. COVID-19 infeksiyasi anamnezi bo’lgan O’KS-ST bemorlarda yurak-qon tomir o’limi, qayta ishemiyaga bog’liq revaskulyarizatsiya va MACE hodisalari chastotasi sezilarli darajada yuqoriligi aniqlandi. bTOKA TLTga nisbatan samaraliroq bo’lib, uzoq muddatli prognozni yaxshiladi. COVID-19 infeksiyasi O’KS-ST bemorlarida mustaqil salbiy prognostik omil hisoblanadi.
Kalit so’zlar: COVID-19, O’KS-ST, reperfuziya terapiyasi, trombolizis, bTOKA, MACE.
Аннотация. Исследование оценивало влияние перенесенной ранее COVID-19 на эффективность и безопасность реперфузионной терапии у пациентов с острым коронарным синдромом с подъемом сегмента ST (ОКСпST). У пациентов с COVID-19 частота MACE была значительно выше, при этом первичная чрескожная коронарная интервенция (пЧКВ) обеспечивала более благоприятный долгосрочный прогноз по сравнению с тромболитической терапией (ТЛТ).
Материалы и методы. В 2021-2024 годах в Республиканском специализированном центре кардиологии было проведено наблюдение за 200 пациентами в течение 24 месяцев. Пациенты были разделены на группы в зависимости от анамнеза COVID-19: COVID-положительные (n=75) и COVID-отрицательные (n=125). Каждая группа дополнительно делилась в зависимости от вида реперфузионной терапии (ТЛТ или пЧКВ). Проводился статистический анализ клинических, лабораторных, эхокардиографических и ангиографических показателей, а также частоты MACE.
Выводы. У пациентов с ОКС-ST и перенесенной COVID-19 наблюдалась значительная частота сердечно-сосудистой смерти, необходимости повторной ишемической ревскуляризации и MACE. пЧКВ была более эффективной по сравнению с ТЛТ, улучшая долгосрочный прогноз. Перенесенная COVID-19 является независимым неблагоприятным прогностическим фактором у пациентов с ОКС-ST.
Ключевые слова: COVID-19, ОКСпST, реперфузионная терапия, тромболизис, пЧКВ, MACE.
References
- 1. Khan, M. A. B., Hashim, M. J., Mustafa, H., et al. (2020). Global epidemiology of ischemic heart disease: Results from the Global Burden of Disease Study. Cureus, 12(7), e9349. https://doi.org/10.7759/cureus.9349.
- 2. Current trends in the classification of sudden cardiac death based on autopsy derived data: A review of investigations into the etiology of sudden cardiac death. Revista Española de Cardiologia (English Edition). Retrieved from https://www.revespcardiol.org/en-current-trends-in-classification-sudden-articulo-S1885585710000319.
- 3. Ibanez, B., James, S., Agewall, S., et al. (2018). 2017 ESC guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. European Heart Journal, 39(2), 119–177.
- 1. Semenova, I. G., Sheglov, A. N., Semigolovskii, N. Yu., Ballyuzek, M. F., Mazurenko, S. O., Guslev, A. B., Kozaev, A. V., & Nikolskaya, E. M. (2024). Cardioprotection with levocarnitine intracoronary administration during percutaneous coronary interventions. Medical Council (Meditsinskiy sovet), 23, 50–59. https://doi.org/10.21518/ms2023-448.
- 4. World Population Review. (2025). Heart disease rates by country 2025 [Internet]. Walnut, CA: World Population Review. Retrieved January 16, 2025, from https://worldpopulationreview.com/country-rankings/heart-disease-rates-by-country
- 5. Zeymer, U., Ludman, P., Danchin, N., et al. (2021). Reperfusion therapies and in-hospital outcomes for ST-elevation myocardial infarction in Europe: The ACVC-EAPCI EORP STEMI Registry of the European Society of Cardiology. European Heart Journal, 42(44), 4536–4549.
- 6. Pessoa-Amorim, G., Camm, C. F., Gajendragadkar, P., et al. (2020). Admission of patients with STEMI since the outbreak of the COVID-19 pandemic: A survey by the European Society of Cardiology. European Heart Journal - Quality of Care and Clinical Outcomes, 6(3), 210–216.
- 7. World Health Organization. Coronavirus disease (COVID-19): Situation Reports. WHO, 2020.
- 8. Garcia, S., Albaghdadi, M. S., Meraj, P. M., et al. (2020). Reduction in ST-segment elevation cardiac catheterization laboratory activations in the United States during COVID-19 pandemic. Journal of the American College of Cardiology, 75(22), 2871–2872.
- 9. Zheng, Y. Y., Ma, Y. T., Zhang, J. Y., & Xie, X. (2020). COVID-19 and the cardiovascular system. Nature Reviews Cardiology, 17(5), 259–260.
- 10. Libby, P., & Luscher, T. (2020). COVID-19 is, in the end, an endothelial disease. European Heart Journal, 41(32), 3038–3044.
- 11. Long, B., Brady, W. J., Koyfman, A., & Gottlieb, M. (2020). Cardiovascular complications in COVID-19. American Journal of Emergency Medicine, 38(7), 1504–1507.
- 12. Centers for Disease Control and Prevention [CDC], 2023; World Health Organization (WHO), 2020.
- 14. Mafham, M. M., Spata, E., Goldacre, R., et al. (2020). COVID-19 pandemic and admission rates for and management of acute coronary syndromes in England. The Lancet, 396(10248), 381–389.
- 15. Chew, N. W. S., Ow, Z. G. W., Teo, V. X. Y., et al. (2022). The global impact of the COVID-19 pandemic on STEMI care: A systematic review and meta-analysis. Canadian