Негативний вплив поєднання гострого інфаркту міокарда, активного COVID-19 та факторів, асоційованих із воєнним часом, на особливості віддаленого післяінфарктного періоду

The aim – to identify markers of long-term cardiovascular risk in patients with acute myocardial infarction (AMI) with concomitant active COVID-19 and in patients with AMI during wartime, and to evaluate the impact of these factors on the course of the post-infarction period.Materials and methods. A cohort of 160 patients with AMI was examined (mean age 64 years; 78 % men). The first group (n=80) was treated before the COVID-19 pandemic and served as a control group. The second group (n=31) was treated during the pandemic with active concomitant SARS-CoV-2 infection. The third group (n=49) was treated during wartime in Ukraine and had no active COVID-19 infection. All patients received standard in-hospital treatment according to current guidelines with appropriate clinical and laboratory evaluation. Patients who died during hospitalization were excluded. All enrolled patients underwent a 2-year follow-up. Outcomes included all-cause mortality, major cardiovascular events, and a composite endpoint of death or cardiovascular events.Results and discussion. Patients with concomitant COVID-19 demonstrated a higher rate of long-term mortality (19.4 % vs 7.5 % in controls, p=0.1), whereas patients with AMI during wartime had the highest rate of nonfatal cardiovascular events (46.9 % vs 27.5 % in controls, p 15 % on day 1 of AMI and > 18 % on days 5–10), as well as a composite scale incorporating in-hospital lymphocyte percentages, total bilirubin, and HDL cholesterol measured on day 1 (sensitivity 91.7 %, specificity 87.5 %, p 2 significant (> 70 %) or > 3 total coronary stenoses (sensitivity 76.2 %, specificity 95 %, p