How Stable Ischemic Heart Disease Leads to Acute Coronary Syndrome in COVID-19?

Main Article Content

Melika Shafeghat
Arya Aminorroaya
Nima Rezaei

Keywords

Severe Acute Respiratory Syndrome Coronavirus 2, Acute Coronary Syndrome, Coronary Artery Disease, Stable Ischemic Heart Disease, Stable Coronary Artery Disease, Out-of-Hospital Cardiac Arrest, Coronavirus Disease 2019, COVID-19

Abstract

Since the beginning of the coronavirus disease 2019 (COVID-19) pandemic, the increased mortality risk of patients with underlying cardiovascular diseases and COVID-19 was raised. Besides, coronavirus itself enhances the incidence of myocardial injury, which suggests a two-sided relation. We aimed to discuss the role of COVID-19 in the progression of stable coronary artery disease (CAD) to acute coronary syndrome (ACS), which might lead to a greater rate of out-of-hospital cardiac arrest and a higher fatality rate of ACS during the pandemic. We briefly reviewed several mechanisms in this regard: Systemic inflammation and cytokine release in critical patients; Plaque rupture and coronary thrombosis; Dysregulation of cytotoxic T-cell lymphocytes; Malignant ventricular arrhythmias. We reinforce applying more attention to COVID-19 patients with stable CAD during follow-up to prevent progression to ACS. These individuals should seriously observe World Health Organization protocols to avoid virus transmission by carriers.

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