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Funding Acknowledgements Type of funding sources: None. Physical and psycho-emotional stress during the war can provoke an aggravation of cardiovascular pathology and contribute to the development of in-hospital complications. The aim of our work was to analyze pts admitted to emergency cardiology department in our city during the first months (from February 24 to May 31, 2022) of 2022 russian full-scale invasion of Ukraine and compared their clinical characteristics and the course of in-hospital period with patients hospitalized during the same period of 2019 (pre COVID-19 era). The total number of pts hospitalized in 2022 was half as much as in 2019 (98 pts vs. 202 pts), which can be partly explained by civilian migration and mobilization. The average age of patients (62.8±12.7 yo in 2019 vs 64.8±13.6 yo in 2022, p>0.05) and the number of women (27.2% vs 33.7%, p>0.05) did not change. There were no changes in main causes of hospitalizations: ACS (58.9% in 2019 vs 61.2% in 2022, p>0.05), ADHF (22.8% vs 18.4%, p>0.05), hypertensive urgencies (10.9% vs 14.3%, p>0.05), arrhythmias (4.4% vs 6.2%, p>0.05). 98 pts and 49 patients with STEMI were treated during studied periods of 2019 and 2022, accordingly. There were no significant differences in the main clinical characteristics between groups. The GRACE score in groups was almost the same (154.3±33.0 pts vs 160.8±43.5 pts, p=0.366). Cardiogenic shock at admission was diagnosed in slightly less than 10% of pts, Killip II or III in about 20% of pts with no difference between groups. Despite the absence of a significant difference in the level of arterial pressure, heart rate at admission was 10 bpm more during the wartime (84,0±15,4 bpm vs 74,9±20,6 bpm, p=0.005). 88.7% of STEMI pts in 2019 and 75.5% of pts in 2022 (p=0.064) were admitted during the first 24 hrs after symptoms onset. The mean time to hospitalization in this pts was 4.4±3.8 hrs in 2019 and 6.4±5.6 hrs this year (p=0.044). This time delay led to a lower number of pPCI made during the wartime (82.5% vs. 59.2%, p=0.005), despite the same total number of angio (90.7% in 2019 vs. 91.5% in 2022, p=0.821) and PCI (86.6% in 2019 vs. 79.6% in 2022=0.304). No-reflow (TIMI During the first months of hostilities, the structure of hospitalization in the emergency cardiology department did not change. Patients with STEMI were hospitalized later and had a greater number of in-hospital complications.

Funding Acknowledgements Type of funding sources: None. Patients with cardiovascular pathology have a significantly higher risk of adverse events and death when complicated by concomitant COVID-19. The aim of this study was to analyze in-hospital mortality in pts with acute cardiovascular pathology (ACP) and a co-infection with COVID-19. 139 pts with ACP who were diagnosed with COVID-19 were examined. 69 (49.6%) pts had ACS (47 pts with AMI), 33 (23.7%) pts - hypertensive urgency, 24 (17.3%) pts - ADHF, 9 (6.5%) pts - tachysystolic paroxysm of atrial fibrillation, 2 (1.4%) pts - acute pulmonary embolism, and 2 (1.4%) pts - syncope. The average age was 67.9±12.7 y.o., 70 (50.4%) pts were male. Concomitant arterial hypertension was found in 87.1%, DM – 20.9%, CHF - 30.9%, COPD – 9.4% of pts, history of AMI – 20.1% and ischemic stroke – 9.4% of pts. In 79 (56.8%) pts COVID-19 was diagnosed and laboratory confirmed before hospitalization (hospitalized in 5.3±3.6 days after symptoms onset). 31 (22.3%) pts were diagnosed with COVID-19 upon admission, and 29 (20.9%) - during their stay in the hospital. 20 (15.6%) pts were vaccinated against COVID-19. The initial SpO2 level was 91.6±10.3%, while more than half of pts (53.2%) had SpO2 During the hospital period, 20 (14.4%) pts died. The mortality rate was 28.0% in pts with ADHF, 19.1% in pts with AMI and significantly less in pts hospitalized for unstable angina, hypertensive urgency or atrial fibrillation - 5.2% (p Co-infection with COVID-19 worsens treatment outcomes and in-hospital mortality of patients with ACP. Vaccination significantly reduces the likelihood of complications and tends to reduce mortality.

Background Cardio-vascular death (CVD) in patients with acute myocardial infarction (AMI) significantly decreased due to reperfusion and advances in pharmacotherapy. Acute heart failure (AHF) remains a common and unfavorable AMI-related complication. Aim To determine the incidence and prognostic value of Killip Class II–IV of AHF in long term follow-up of patients with ST-elevation myocardial infarction (STEMI). Methods All patients with STEMI were admitted to our emergency cardiology department during 1995–2011. CVD up to ten years after STEMI was the main outcome endpoint. We compared CVD in patients with and without AHF, and revascularization. Survival curve was generated by the Kaplan-Meier method. Predictors of mortality after STEMI were determined by multivariable Cox regression. Results Prospective cohort study includes 1625 STEMI patients; the mean age of the patients was 54.4±0.3 years, time from symptom onset was 5.0±0.2 hour, 1497 were men (92.1%), and 899 patients (55.5%) were revascularized (TLT – 632 (38.9%), PCI – 267 (16.4%), including 159 patients with stent implantation (9.8%). 412 patients had AHF - Killip Class II–IV (25.4%) during first 24 hours. Ten-year survival after STEMI was 85%; survival exceeded 88% in patients without AHF, but was 75% for those with AHF. Among patients who underwent revascularisation ten-year survival was 82.9% for patients in group with AHF, and was 87.1% for those without AHF. In multivariable Cox regression, age ≥65 years, female gender and HF were the predictive factors for CVD. Kaplan-Meier survival curves demonstrated higher incidence of CVD in AHF patients in compare with those without AHF in long-term follow-up (Figure 1). Conclusion According to the study AMI care is associated with high rates of long term survival, ten-year rates exceed 85%. AHF during first 24 hour in patients with STEMI worsens the prognosis, but reperfusion therapy increases survival. Further efforts to improve survival should be directed to patients with AHF and low revascularization rate that are associated with poor survival after AMI. Funding Acknowledgement Type of funding sources: None.