Therapeutic Implications of COVID-19 for the Interventional Cardiologist. (May 2021)

• Record Type: Journal Article
• Authors: Kelham, Matthew; Choudry, Fizzah A.; Hamshere, Stephen; Beirne, Anne-Marie; Rathod, Krishnaraj S.; Baumbach, Andreas; Ahluwalia, Amrita; Mathur, Anthony; Jones, Daniel A.
• Is Part Of: Journal of cardiovascular pharmacology and therapeutics. Volume 26:Number 3(2021)
• Page Start: 203
• Page End: 216
• Publication Date: 2021-05
• Subjects: COVID-19 -- ST-segment elevation myocardial infarction -- primary percutaneous coronary intervention -- thrombosis -- myocardial injury; Cardiovascular pharmacology -- Periodicals; Cardiovascular system -- Diseases -- Treatment -- Periodicals; 616
• DOI: 10.1177/1074248420982736
• Languages: English
• ISSNs: 1074-2484

Abstract

Although COVID-19 is viewed primarily as a respiratory disease, cardiovascular risk factors and disease are prevalent among infected patients and are associated with worse outcomes. In addition, among multiple extra-pulmonary manifestations, there has been an increasing recognition of specific cardiovascular complications of COVID-19. Despite this, in the initial stages of the pandemic there was evidence of a reduction in patients presenting to acute cardiovascular services. In this masterclass review, with the aid of 2 exemplar cases, we will focus on the important therapeutic implications of COVID-19 for interventional cardiologists. We summarize the existing evidence base regarding the varied cardiovascular presentations seen in COVID-19 positive patients and the prognostic importance and potential mechanisms of acute myocardial injury in this setting. Importantly, through the use of a systematic review of the literature, we focus our discussion on the observed higher rates of coronary thrombus burden in patients with COVID-19 and acute coronary syndromes.