Characteristics of patients with acute coronary syndrome in the Clinical Hospital Sveti Duh during the COVID 19 pandemic: a retrospective study

Uvod: Akutni koronarni sindrom (AKS) je stanje akutne i kritične ishemije miokarda. Najčešće se manifestira kao nestabilna angina pektoris i infarkt miokarda. Riječ je o sindromu koji se ubraja među najveće hitnosti u kardiologiji i medicini općenito. Utjecaj SARS-CoV-2 virusa na srce je višeznačan, od razvoja mogućeg miokarditisa, stvaranja tromboze u malim krvnim žilama i posljedične nekroze, ali i pojave infarkta miokarda po tipu 2 te razvoja klasičnog AKS, infarkta miokarda tipa 1. Za optimalno liječenje ovih bolesnika potrebno je adekvatno razumijevanje međudjelovanja COVID-19 i kardiovaskularnih bolesti. Cilj: Ispitati karakteristike oboljelih od AKS hospitaliziranih na Zavodu za bolesti srca i krvnih žila u Kliničkoj bolnici Sveti Duh prije i tijekom pandemije COVID–19. Metode: Retrospektivnim istraživanjem uspoređene su dvije skupine bolesnika oboljelih od AKS u periodu od siječnja do prosinca 2018. godine i siječnja do prosinca 2020. godine. Rezultati: Analizirani su podaci 729 bolesnika. Najučestaliji rizici prisutni kod bolesnika su šećerna bolest i pušenje, bez značajne razlike u odnosu na promatrane godine. Hipertenzija je učestalija tijekom 2020., a dislipidemija je značajnije prisutna tijekom 2018. godine. Bolesnici hospitalizirani 2020. godine značajno su veće tjelesne mase, kao i većeg indeksa tjelesne mase, u odnosu na 2018. godinu. S obzirom na dijagnozu, tijekom 2020. godine značajnije su učestaliji infarkt miokarda sa ST–elevacijom (STEMI) i nestabilna angina pektoris (NAP), a tijekom 2018. godine infarkt miokarda bez ST–elevacije (NSTEMI). Broj dana hospitalizacije značajno je dulji tijekom 2018. godine (medijan 5 dana) u odnosu na 2020. godinu (4 dana). Zaključak: Tijekom pandemijske 2020. godine niti jedan hospitalizirani bolesnik s AKS nije prethodno prebolio COVID. Samo dva bolesnika su uz infekciju COVID-19 imala i AKS. Nije postojala značajna razlika u broju hospitalizacija kao ni u strukturi bolesnika u istraživanim razdobljima. Tijekom pandemije bilo je više bolesnika s hipertenzijom i veće tjelesne mase, a manje s dislipidemijom.Background: Acute coronary syndrome (ACS) is a condition of acute and critical myocardial ischemia. It is most often manifested as unstable angina pectoris and myocardial infarction. It is a syndrome that is considered among the greatest emergencies in cardiology and medicine in general. The impact of the SARS-CoV-2 virus on the heart is multifaceted, from the development of possible myocarditis, the formation of thrombosis in small blood vessels and consequent necrosis, but also the occurrence of type 2 myocardial infarction and the development of classic ACS, type 1 myocardial infarction. For optimal treatment of these patients an adequate understanding of the interaction between COVID-19 and cardiovascular diseases is needed. Aim: To examine the characteristics of acute coronary syndrome patients hospitalized at the Institute for Heart and Blood Vessel Diseases at the Sveti Duh Clinical Hospital before and during the COVID-19 pandemic. Methods: A retrospective study compared two groups of patients with ACS in the period from January to December 2018 and January to December 2020. Results: The data of 729 patients were analyzed. The most common risks present in patients are diabetes and smoking, with no significant difference compared to the observed age. Hypertension is more frequent in 2020, and dyslipidemia is more significant in 2018. Patients hospitalized in 2020 have a significantly higher body mass, as well as a higher body mass index, compared to 2018. With regard to the diagnosis, in 2020 ST-elevation myocardial infarction (STEMI) and unstable angina pectoris (NAP) are significantly more frequent, and in 2018 non-ST-elevation myocardial infarction (NSTEMI). The number of days of hospitalization was significantly longer in 2018 (median 5 days) compared to 2020 (4 days). Conclusion: During the pandemic year 2020, not a single hospitalized patient with ACS had previously recovered from COVID. Only two patients had ACS in addition to the COVID-19 infection. There was no significant difference in the number of hospitalizations or in the structure of patients in the investigated periods. During the pandemic, there were more patients with hypertension and higher body mass, and fewer with dyslipidemia