Insights for increased risk of failed fibrinolytic therapy and stent thrombosis associated with <scp>COVID</scp>‐19 in <scp>ST</scp>‐segment elevation myocardial infarction patients

Lacour, Thibaud; Semaan, Carl; Genet, Thibaud; Ivanès, Fabrice

doi:10.1002/ccd.28948

Cited by 42 publications

(45 citation statements)

References 12 publications

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“…Antifibrinolytic therapy followed by rescue coronary angioplasty failed to protect a patient with a previous ST-segment elevation myocardial infarction and COVID-19 (without clinical manifestations) against 2 successive episodes of stent thrombosis. The authors of the article suspect a possible platelet hyperaggregability induced by SARS-CoV-2 virus infection, for which they recommend rapid revascularization associated with the use of new generation P2Y12 inhibitors and GPIIb/IIIa inhibitors 69 .…”

Section: The Management Of Vascular Prosthetic Grafts In Patients Witmentioning

confidence: 99%

Coagulation disorders in SARS-CoV-2 infection

Mihăilă¹,

Mihaila²

2020

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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A better understanding of the pathogenetic mechanisms triggered by SARS-CoV-2 infection may contribute to a more effective management of patients with COVID-19. Coagulation dysfunction is a key pathogenetic element of this disease as well as a challenge for practitioners. Marked inflammatory process found in severe forms of COVID-19, the complement activation, the cytokine storm, and disruption of the renin-angiotensin-aldosterone system are involved in the onset of thrombotic microangiopathy and large vessel coagulopathy. Virus-induced procoagulant activity occurs at the systemic level. Intravascular microthrombi disrupt vascularization in various tissues and organs, contributing to the occurrence of multiorgan failure and explain the higher morbidity and all-cause mortality of patients. It is estimated that almost 20% of patients with COVID-19 have significant coagulation disorders, and about a quarter of those hospitalized in intensive care units are prone to develop thrombosis events under prophylactic anticoagulant treatment. Some of patients who have been immunized after healing from the SARS-CoV-2 infection have a hypercoagulable state and are prone to develop thrombosis. Hypercoagulability is supported by thrombelastographic analysis: patients have an acceleration of the propagation phase of blood clot formation and higher clot strength. Markers of coagulation dysfunction in SARS-CoV2 are: decreased platelet count, increased INR, presence of fibrin degradation products, and especially higher plasma levels of D-dimers, which predict unfavorable outcome in these patients. Age, pre-existing diseases and associated risk factors, together with careful monitoring of clinical evolution and laboratory parameters allow the choice of the best personalized prophylactic or curative anticoagulant treatment.

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Section: The Management Of Vascular Prosthetic Grafts In Patients Witmentioning

confidence: 99%

Coagulation disorders in SARS-CoV-2 infection

Mihăilă¹,

Mihaila²

2020

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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“…Additionally, excessive platelet aggregability may play a role resulting in in-stent thrombosis. The importance of anti-platelet drugs in this scenario should be reconsidered [64]. One recent article has discussed an interesting point regarding the use of ticagrelor.…”

Section: Newer Agentsmentioning

confidence: 99%

Management of Thrombotic Complications in COVID-19: An Update

Hajra

Mathai

Ball

et al. 2020

Drugs

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Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is now a global pandemic. This virus primarily affects the respiratory tract and causes lung injury characterized by acute respiratory distress syndrome. Although the pathophysiology of COVID-19 is not yet clear, the most widely accepted mechanism is systemic inflammation. A clinically significant effect of the inflammation is coagulopathy. As a result of this effect, patients are found to have a high risk of venous thromboembolism. Studies have reported a high incidence of thrombotic complications in critically ill patients with COVID-19. In this review, we discuss the most updated evidence on the pathophysiology, diagnosis, and treatment of the coagulopathy of COVID-19. Prophylactic anticoagulation is recommended for all in-patients with COVID-19. Those with a higher risk of developing thromboembolic events or who have already developed venous thromboembolism should be treated with therapeutic anticoagulation. We also discuss post-discharge prophylaxis for highrisk patients and some newly proposed treatments for the hypercoagulability that could improve the outcomes of the affected patients.

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“…131 Thrombotic complications also emerge in patients with COVID-19. [132][133][134][135] COVID-19 patients have elevated D-dimer levels, prolonged prothrombin times, and thrombocytopenia similar to DIC. 132,[136][137][138] Both elevated D-dimer levels and thrombocytopenia can be explained by excessive activation of platelets and the coagulation cascade.…”

Section: Cytomegalovirus (Cmv)mentioning

confidence: 99%

<p>Extracellular Vesicle-Related Thrombosis in Viral Infection</p>

Nomura

Taniura²,

Ito

2020

IJGM

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Although the outcomes of viral infectious diseases are remarkably varied, most infections cause acute diseases after a short period. Novel coronavirus disease 2019, which recently spread worldwide, is no exception. Extracellular vesicles (EVs) are small circulating membrane-enclosed entities shed from the cell surface in response to cell activation or apoptosis. EVs transport various kinds of bioactive molecules between cells, including functional RNAs, such as viral RNAs and proteins. Therefore, when EVs are at high levels, changes in cell activation, inflammation, angioplasty and transportation suggest that EVs are associated with various diseases. Clinical research on EVs includes studies on the coagulatory system. In particular, abnormal enhancement of the coagulatory system through EVs can cause thrombosis. In this review, we address the functions of EVs, thrombosis, and their involvement in viral infection.

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Insights for increased risk of failed fibrinolytic therapy and stent thrombosis associated with COVID‐19 in ST‐segment elevation myocardial infarction patients

Cited by 42 publications

References 12 publications

Coagulation disorders in SARS-CoV-2 infection

Coagulation disorders in SARS-CoV-2 infection

Management of Thrombotic Complications in COVID-19: An Update

<p>Extracellular Vesicle-Related Thrombosis in Viral Infection</p>

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