Invasively managed acute and chronic coronary syndromes during the first wave of the COVID-19 pandemic: one-year outcomes

Abstract

To the Editor, Acute SARS-CoV-2 infections (COVID-19) have caused a global pandemic since the first cases were described in Wuhan, China, back in December 2019. The first wave of COVID-19 cases in Western Europe led to substantial healthcare disruption and population lockdowns from March 2020 through May 2020. Regarding the cardiovascular implications, COVID-19 has been associated with higher in-hospital mortality rates in patients with coronary syndromes.1 Among others, a higher thrombogenic risk has been proposed as the underlying mechanism of this increased rate of adverse events.2 Subsequently, observational studies have suggested an increased number of stent thrombosis during acute COVID-19 infections.3 The underlying mechanisms of this stent thrombosis are endotheliitis, platelet activation, and coagulopathy. It is unknown whether these mechanisms could also lead to late adverse cardiovascular events or stent failure. We previously reported on an increased 30-day mortality rate in patients with acute coronary syndrome and COVID-19 compared to non-COVID-19 patients.4 Later studies confirmed similar rates of death after myocardial infarction.5 This study aimed to analyze the 1-year rate of adverse cardiovascular events and stent failure in consecutive patients referred for coronary angiography from March through April 2020. All the participant patients gave their informed consent and the project was approved by...