Studying associative relations between left ventricular dysfunction and heart failure development in patients with acute coronary syndrome and clinical manifestation of COVID-19

The aim of the work: to determine associative relations between left ventricular dysfunction and heart failure development in patients with acute coronary syndrome and COVID-19. Materials and methods. Patients with acute coronary syndrome and manifestation of COVID-19 were included in the study (n = 100). The material for the analysis was the data of echocardiography and coronary angiography. The study participants underwent myocardial revascularization. Results. It has been found that ejection fraction before reperfusion was 2.4 % higher in the main group (p ≥ 0.05), and it was increased by an average of 1.2 % (p ≥ 0.05) after reperfusion. In the comparison group, the mean value of ejection fraction did not differ before and after reperfusion. A comparative analysis of ejection fraction after reperfusion has shown its increase by an average of 52.0 % in the main group and by 48.0 % in the comparison group, indicating the treatment effectiveness. The determined OR coefficients have indicated a 0.85-fold reduced heart failure risk in the comparison group (OR = 0.85; 95 % CI: 0.36–2.01, p = 0.8). A 0.78 times decreased heart failure risk has been revealed in patients with unchanged ejection fraction after reperfusion in the comparison group (OR = 0.78; 95 % CI: 0.26–2.31, p = 0.8), while it has been shown to be 1.47 times higher in those with decreased ejection fraction (OR = 1.47; 95 % CI: 0.57–3.79, p = 0.5). Conclusions. The determined OR coefficients have demonstrated associative relations between a reduction in the heart failure risk in single-vessel (OR = 0.67; 95 % CI: 0.06–7.31, p = 0.5), two-vessel (OR = 0.40; 95 % CI: 0.01–10.17, p = 0.5) and multivessel (OR = 0.79; 95 % CI: 0.26–2.38, p = 0.8) coronary artery lesions after effective reperfusion in the comparison group. Associative relations between increased risk of heart failure have been established in single-vessel (OR = 4.67; 95 % CI: 0.29–90.01, p = 0.4) and multivessel (OR = 3.29; 95 % CI: 0.74–16.66, p = 0.01; χ2 = 5.71) coronary artery lesions after ineffective revascularization.