To Evaluate the Results of Coronary Stent Implantation with Different Drug-Eluting Agents in Patients with Acute Myocardial Infarction, COVID-19, and Viral Pneumonia with Different In-Hospital Outcomes (Recovery or Death)

Evaluation of the results of implantation of coronary stents with different drug-eluting agents in patients with acute myocardial infarction, COVID-19, and viral pneumonia with different in-hospital outcomes (recovery or death). RELEVANCE. After infection with the coronavirus disease 2018 (SARS - CoV -2), a person may be at increased risk for both acute non-ischemic myocardial injury and acute myocardial infarction, especially type 2. Timely interventional coronary artery revascularization after thrombosis does not always restore patency due to rethrombosis and inflammation. Several studies conducted in Europe and the United States involving coronary angiography and percutaneous coronary intervention (PCI) in patients with acute coronary syndrome (ACS) and COVID-19 confirm the validity of pathophysiologists' concepts regarding the nature of coronary and myocardial inflammatory and thrombotic injuries. THE AIM OF THE STUDY WAS to compare the frequency of use of coronary stents with different coatings in selected groups of patients with acute myocardial infarction, COVID-19 infection, and viral pneumonia, depending on the in-hospital outcome: hospital discharge or death from complications. MATERIAL AND METHODS OF RESEARCH. In The study included 83 patients aged 45 to 85 years with a diagnosis of acute myocardial infarction (AMI) or unstable angina with viral pneumonia (or acute gas exchange disorders) and COVID-19, hospitalized for emergency indications. All patients with AMI underwent pulse oximetry, complete blood count (CBC), blood biochemistry, clinical (general) urinalysis (CUA), coagulation profile, multispiral computed tomography (MSCT) of the lungs, and COVID-19 virus infection diagnostics using polymerase chain reaction (PCR) in oropharyngeal and nasopharyngeal swabs. Renal nitrogen excretion function was assessed dynamically based on changes in serum creatinine concentrations. Clinical, electrocardiographic, angiographic (coronary angiography) and biochemical (enzyme) criteria for acute coronary syndrome and myocardial infarction with and without ST segment elevation were used. X-ray contrast coronary angiography (CAG) was performed on Artis Zee, Siemens, Healthinners (Germany) and Azurion 3 Philips (Netherlands) angiographs. CAG And transluminal balloon coronary angioplasty (TBCA) methodology Elchaninoff H. and co-authors [1], through radial, less often through femoral arterial access. Mechanical recanalization, balloon angioplasty and stenting of coronary arteries were performed using balloon dilation in 59 patients. STUDY RESULTS: In X-ray contrast coronary angiography of deceased patients with ACS and COVID-19, more severe atherosclerotic coronary lesions were diagnosed in the anterior descending coronary artery. The incidence of coronary occlusion was approximately similar in the two compared groups of deceased and surviving patients, averaging 58% and 46%, with acute forms predominating, accounting for 83-92% of all cases. Implantation of serolimus-eluting coronary stents during PCI was associated with a significantly higher mortality rate in the surviving group, by an average of 25.3%. Conversely, the use of zotoralimus-eluting stents showed a significant positive trend in the survival of patients with AMI and COVID-19 after coronary intervention. CONCLUSIONS: Analysis of the use of stents with various drug-based antiregeneration coatings in PATIENTS with AMI, COVID-19, and viral pneumonia during primary PCI revealed a link with unfavorable hospital outcomes when using sirolimus-coated stents and, conversely, a positive trend in patient survival after coronary revascularization with the installation of sirolimus-coated stents.