Acute Coronary Syndrome in Patients With COVID-19

Study Overview
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Brief Summary
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The aim of this study was to find a clinical or laboratory parameter, that would help in distinguishing between COVID-19 patients with myocardial infarction (MI), who have an infarct-related artery (IRA) and therefore, require immediate revascularization, and those, who have no IRA.

Detailed Description
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The coronavirus pandemic has hit the world with its vast contagiousness, high morbidity, and mortality Apart from the direct damage to the lung tissue, the corona virus infection is associated with multiple organ damage, including the heart. Emerging evidence reveals a direct correlation between COVID-19 and cardiovascular complications, such as heart failure, myocarditis, arrhythmias, conduction abnormalities and acute coronary syndromes. The SARS-CoV-2 infection can frequently induce coagulation abnormalities that are associated with cardiopulmonary deterioration and death as a possible complication in all patients, despite presence or absence of concomitant risk factors and diseases. In addition, many patients with severe COVID-19 undergo thromboembolic events, which seem to be related to this particular coagulopathy. One of the most unpleasant and life-threatening types of thromboembolism is the one involving the coronary circulation, thus causing a heart attack. Many additional problems arise due to this condition e.g., access to a Cath lab, exposure of additional medical personnel, more complications and increased mortality for the patients. Invasive angiography for COVID-19 patients is logistically challenging and, in some cases, there is no intervention target, since microcirculatory disease and thrombosis is common in this group. Therefore, we studied in detail the case series of 10 patients referred for primary percutaneous coronary intervention (pPCI) for MI in our catheterization laboratory during the course of COVID-19 infection. And we set ourselves the purpose to evaluate if there are some factors or parameters that could predict the presence of an interventional target - infarct related artery (IRA), prior to catheterization, and to determine their sensitivity and specificity.

Official Title
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How to Decide Which COVID-19 Patient With Myocardial Infarction to Send to the Cath Lab? - A Case Series of COVID-19 Patients With Myocardial Infarction

Conditions
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to Find a Clinical or Laboratory Parameter, That Would Help in Distinguishing Between COVID-19 Patients With MI and IRA and Those, Who Have no IRA

Intervention / Treatment
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* Procedure: Coronary angiography


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Acute coronary syndrome (ACS) COVID-19 infection Exclusion Criteria: No combination of ACS and COVID-19 infection

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Patients with ACS and no IRA<br>Patients with acute coronary syndrome (ACS) during a COVID-19 infection, who after undergoing coronary angiography - no infarct-related artery (IRA) is found | Procedure: Coronary angiography<br>* A coronary angiogram is a procedure that uses X-ray imaging to see the patient's blood vessels of the heart. The test is generally done to see if there's a restriction in blood flow going to the heart.<br>|
| Patients with ACS and IRA<br>Patients with acute coronary syndrome (ACS) during a COVID-19 infection, who after undergoing coronary angiography - an infarct-related artery (IRA) is found | Procedure: Coronary angiography<br>* A coronary angiogram is a procedure that uses X-ray imaging to see the patient's blood vessels of the heart. The test is generally done to see if there's a restriction in blood flow going to the heart.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| to find a clinical or laboratory parameter, that would help in distinguishing between COVID-19 patients with MI and IRA and those, who have no IRA |  | During the whole study |