Case Report
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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) called COVID-19 is often associated with thrombotic complications, especially in severe cases. We report a case of COVID-19 revealed by a right intraatrial thrombus to emphasize the risk of thromboembolic diseases linked to this pathology. He was a young subject, 41 years old, with no notable history. He complained of asthenia and precordialgia. Echocardiography showed the presence of a right intraatrial thrombus and laboratory tests confirmed COVID-19. Under medical treatment combining antithrombotics, chloroquine and azithromycin, the thrombus regressed, and the markers of inflammation were normalized after 12 days. One month later, the patient remained clinically stable with normal echocardiography.
Research Article
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In today's world, the growth of technical progress has increased the number of people with obesity, which is one of the main risk factors for the development of acute myocardial infarction (MI).
Objective: To evaluate the effect of obesity on some clinical and anthropometric characteristics in patients with acute MI.
Material and Methods: A special questionnaire - a “registry card” was developed for monitoring patients with acute MI and collecting the necessary and complete information from employees of the Cardiovascular Diseases (CVD) Prevention Department. The presented article describes the data of a preliminary analysis of patients with acute MI treated in the clinic. Of the 202 people, 191 (94.6%) had a body mass index (BMI) calculated. Depending on the level of BMI, three groups were selected: 1 g (BMI < 25 kg/m2) - 36 (18.8% of 191) patients with acute MI with normal weight (control group); 2 g (BMI = 25–30 kg/m2) - 84 (44.0% of 191) overweight people; 3 g (BMI > 30 kg/m2) - 71 (37.2% of 191) people with obesity. Differences were considered significant at p < 0.05.
Results: Despite the fact that acute MI developed in women 2.6 times less frequently and 8.7 years later in age than in men, nevertheless, obesity in women was recorded more often, while in men overweight prevailed. In acute MI between the age of the respondents and the presence of increased weight, an inverse relationship was revealed (p > 0.05), i.e., as the weight category increased, the age of the patients decreased. In patients with MI, as the weight increased, there was an increase in comorbid pathology, especially associated with impaired carbohydrate metabolism (p < 0.0001). A more severe form of MI (STEMI) was more often recorded in persons with a BMI > 25 kg/m2, while the front wall was the most vulnerable to the development of acute MI, regardless of the weight category of patients. The back wall was involved in the pathological process both in individuals with overweight and in patients with obesity. The apical segment in the largest number of cases was only affected in people with obesity.
Conclusion: Obesity is a kind of epidemic of modern society. Its effects on the quality of life, prognosis, and effectiveness of conservative or minimally invasive treatment methods in patients with acute cardiovascular catastrophes, such as acute MI, are still a very controversial issue that requires furthermore in-depth study and analysis.
Original Research
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Introduction: Non-ST-elevation (NSTE) acute coronary syndrome (ACS) is a common and polymorphic condition. Predicting significant coronary artery disease (CAD) is sometimes difficult. The objective of this study was to identify predictors of CAD severity in patients with non-ST-elevation acute coronary syndrome (NSTE-ACS).
Patients and Methods: We prospectively evaluated 296 patients with NSTE-ACS who underwent a coronary angiography. Significant CAD was defined as ≥70% stenosis in at least one major coronary artery. Clinical characteristics in the hospital for 30 days and one-year outcomes were prospectively noted and a multivariate analysis was performed.
Results: The study included 296 NSTE-ACS patients. The mean age of the patients was 62.1 ± 12.6 years old while 58.1% of the patients were males. A multivariable analysis for the significant CAD predictors is shown (Figure 1), representing current smoking (ORa = 4.4; 95% confidence interval [CI] = 1.5–13.0, p = 0.007), a diabetic under insulin (Ora = 6.4; 95% [CI] = 2.4–17.4, p < 10-3), typical angina (ORa = 5.4; 95% [CI] = 1.7–16.8, p = 0.003), persistent angina (ORa = 5.3; 95% [CI] = 1.3–21.8, p = 0.019), recurrence of angina (ORa = 8.9; 95% [CI] = 1.5–51.4; p = 0.015), down sloping ST depression (ORa = 6.1; 95% [CI] = 2.4–15.3, p < 10-3), positive troponin (ORa = 4.2; 95% [CI] = 1.9–9.2, p < 10-3), kinetic disorder > 2 segments (ORa = 2.5; 95% [CI] = 1.1–6.0, p = 0.049), intima-media thickness (IMT) > 0.8 mm (ORa = 5.2; 95% [CI] = 2.3–12.1, p < 10-3).
Conclusion: In this study, the severity of CAD was predicted by parameters such as typical or recurrent angina pectoris, current smoking, diabetic on insulin, down sloping ST depression, elevation of troponin, kinetic anomaly in more than two segments and the IMT greater than 0.8 mm.
