Статья
Острый коронарный синдром у пациентов с COVID-19
Развитие острого коронарного синдрома (ОКС) обусловлено острым несоответствием потребности миокарда в кислороде и его доставкой. Данный механизм в большей мере связан с прогрессированием коронарного атеросклероза в сочетании с воспалительным ответом, гипоксемией, прокоагулянтным состоянием плазмы крови и тромбоцитов. Пациенты с новой коронавирусной инфекцией COVID-19 (COronaVIrus Disease 2019), отягощенные по сердечно-сосудистым заболеваниям и коморбидной патологии, представляют группу высокого риска развития ОКС.Цель. Провести анализ опубликованной литературы, в которой отражены данные о развитии ОКС у пациентов с COVID-19, его патогенезе, особенностях клинического течения.Материал и методы. Поиск литературных данных осуществлялся с помощью сервисов Google Scholar, PubMed, ScienceDirect и Cyberleninka. В анализ были включены данные клинических рекомендаций по ведению пациентов с COVID-19, данные клинических исследований, отчетов и систематических обзоров.Результаты. В настоящем литературном обзоре обобщены и систематизированы данные, представленные в современных научных публикациях, освещены аспекты клинического течения и особенности патогенетических механизмов, лежащих в основе ОКС у больных с COVID-19.Заключение. Патогенез COVID-19 неразрывно связан с распространенным цитопатическим действием SARS-CoV-2 (Severe Acute Respiratory Syndrome CoronaVirus 2, коронавирус 2, вызывающий тяжелый острый респираторный дистресс-синдром), генерацией патологического неконтролируемого иммунного ответа, который обуславливает системное воспаление, а также реализацией прокоагулянтной активации системы гемостаза. У пациентов с COVID-19, наряду с атеросклеротическим процессом, данные механизмы значительно повышают риск развития ОКС и могут ухудшать его течение на госпитальном этапе.
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