ACUTE MYOCARDIAL INFARCTION IN YOUNG ADULTS IN POST COVID ERA IN SSIMS, BHILAI

Abstract

Introduction: The corona virus disease 2019 (COVID-19) pandemic is caused by severe acute
respiratory syndrome corona virus 2 (SARS-CoV-2) and is associated with various disease
manifestations across multiple organ systems, presenting with a spectrum of disease severity that is only partially explained by age, sex and comorbidities. Of note, the manifestations of acute cardiovascular injury associated with SARS-CoV-2 infection are diverse, including acute
myocardial infarction, myocarditis, stress cardiomyopathy, pericarditis, arrhythmias, multisystem inflammatory syndrome in both adults (MIS-A) and children (MIS-C), stroke, macrothrombotic disease including arterial and venous thromboembolism, microthrombotic disease and bleeding diathesis.
Materials and Methods: Total 750 acute myocardial infarction patients were identified; The present study included 150 young patients with acute myocardial infarction in post COVID-19
era in Shri Shankaracharya Institute of Medical Sciences (SSIMS), Bhilai district Durg,
Chhattisgarh. All patients treated with a primary percutaneous coronary intervention (PPCI)
during the period from January 2021 to June 2023. The study was approved by the local ethical
committee. As our study is retrospective and data were collected after patients discharged from the hospital, there is no consent for participation in our study.
Results: Total 750 acute myocardial infarction patients were identified; The present study included 150 young patients with acute myocardial infarction in post COVID-19 era. All patients treated with a primary percutaneous coronary intervention (PPCI) during the period from January 2021 to June 2023. Male patients represented 86.66% (n=130), while female patients represented 13.13% (n = 20). The mean age of the patients were 35.75 years ± 8.76 with range 20-45 years. Regarding traditional risk factors the incidence of diabetes, hypertension, current smoking status, dyslipidemia and obesity were 16.16% (n=25), 8.66% (n=13), 2% (n =3), 9.33% (n = 14), 0.66 (n=1) respectively. The mean heart rate (beat/min), oxygen saturation%, Serum creatinine, CRP, SBP and D-Dimer of our patients were 80, 92.76, 1.3, 86.51, 118, and 650.12 respectively.

Conclusion: After covid era (after 2021) young myocardial infarction patients have increased.
Especially young patients who are smoker and tobacco chewers, these were not confirmed cases
of Covid. A non-obstructive CAD was found in about one third of patients; on the other hand,
patients who had a total occlusion of their culprit artery, the thrombus burden was high.
Identification of the underlying mechanism responsible for the high thrombus burden in these patients is important as it may result in changes in their primary management strategy, either primary PCI, fibrinolytic therapy, or a pharmacoinvasive strategy. Furthermore, adjunctive anticoagulation and antiplatelet therapy may need to be revised