Comprehensive Evaluation of Coronary Pathophysiology in the Context of COVID-19: Clinical Insights and Angiographic Assessment.

Publication date: Jun 25, 2026

The COVID-19 pandemic has severely impacted cardiology, with myocardial injury and new-onset cardiac dysfunction observed even without respiratory symptoms. The Aim of the study aimed to evaluate angiographic and clinical characteristics of COVID-19-positive patients who were presented with acute coronary syndrome. This retrospective case-control study involved 80 COVID-19-positive patients with acute coronary syndrome who underwent angiography, compared to matched COVID-19-negative controls. Conducted at King Saud Medical City, Riyadh, between June 2021 and July 2022. It included angiographic, echocardiographic and laboratory evaluations. 80 (1. 6%) of 5134 COVID-19 patients underwent coronary angiography for coronary artery disease over 14 months. The COVID-19-positive and control groups were primarily male (78. 75% vs. 75%) and had similar mean ages (57. 1+/-10. 86 vs. 55. 93+/-10 years). The control group had higher rates of diabetes (81. 3% vs. 66. 3%) and hypertension (85% vs. 57. 5%), while the COVID-19 group had higher smoking rates, STEMI (50% vs. 26. 3%), and elevated D-dimer, C reactive protein (CRP), and cardiac troponins. COVID-19 patients had more ventricular thrombus (15% vs. 3. 75%), RV dilation (36. 25% vs. 11. 25%), and pulmonary hypertension (50% vs. 26. 3%). COVID-19 patients had more single-vessel disease (35% vs. 17. 5%), and controls had more three-vessel disease (47. 5% vs 22. 5%). The COVID-19 group also used more thrombus aspiration (17. 5% vs. 5%) and glycoprotein IIb/IIIa inhibitors (37. 5% vs. 6. 33%). The findings of this study show that COVID-19 increases cardiovascular injury. Even if the cause is unknown, cardiac injury must be detected quickly. ACS, including STEMI, can kill if not diagnosed and treated immediately. All COVID-19-positive patients with chest pain should be treated with a high index of suspicion due to the risk of coronary thrombosis due to hypercoagulability.

Concepts Keywords
Cardiology Acute Coronary Syndrome
Diabetes Acute Coronary Syndrome
June Aged
Pandemic Cardiovascular diseases
Cardiovascular Risk Factors
Case-Control Studies
Coronary Angiography
Coronary Angiography
COVID-19
COVID-19
Echocardiography
Female
fibrin fragment D
Humans
Male
Middle Aged
Retrospective Studies
SARS-CoV-2

Semantics

Type Source Name
disease MESH COVID-19
disease MESH injury
disease MESH acute coronary syndrome
disease MESH included
disease MESH coronary artery disease
disease MESH hypertension
disease MESH STEMI
disease MESH thrombus
disease MESH pulmonary hypertension
drug DRUGBANK Sulodexide
disease MESH chest pain
disease MESH coronary thrombosis
disease MESH hypercoagulability
disease MESH Long Covid
disease MESH Cardiovascular diseases
drug DRUGBANK Fibrinogen Human

Original Article

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