The coagulation, fibrinolytic, anticoagulation, and complement systems are in delicate balance with the vessel wall endothelium ensuring appropriate hemostasis. Coagulopathy in coronavirus disease 2019 (COVID-19) is not a simple disorder of one hemostatic component but a complicated process affecting most of the hemostasis system. COVID-19 disturbs the balance between the procoagulant systems and the regulatory mechanisms. Here, we investigate the effect of COVID-19 on key hemostatic components, including platelets, endothelial cells, coagulation factors, fibrinolytic system, anticoagulant protein system, and complement system, to improve our understanding of the pathophysiological processes underlying COVID-19 coagulopathy based on evidence.
Introduction: Coronary artery disease is the leading cause of death worldwide and
electrocardiogram (ECG) is a reliable diagnostic tool to determine a myocardial infarction. The
present study tried to compare the relationship between the ECG findings and angiographic
findings in patients with acute anterior myocardial infarction.
Methods: Seventy-four patients with acute anterior ST elevation myocardial infarction (Ant-
STEMI) presenting to the emergency room in the first 12 hours after the onset of symptoms were
studied. Upon admission, a full 14-lead ECG (including leads V3R and V4R) were performed.
Angiographic and ECG findings, as well as clinical outcome were compared between two groups.
The statistical tests including Chi-square and independent t-test were used for data analysis.
Results: Small conus branch was seen in 52 (70.3%) and large conus in 22 ( 29.7%) patients. STE
in right-sided leads and heart failure were significantly higher in small conus branch group versus
large conus branch (88.6% vs 11.4%, P < 0.001 and 34.6% vs 9.1%, P = 0.02 respectively). There
was no significant difference in mortality rate between the two groups (5.8% in small conous
group vs 0% in large conus group, P = 0.55). There was a significant difference in major adverse
cardiac events (MACE) between the two groups (51.9% in small conous group vs 18.2% in large
conus group, P = 0.01).
Conclusion: In patients with anterior MI, small conus branch was associated with higher rate of
major adverse cardiac events mostly because of increased rate of acute heart failure.
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