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<article article-type="research-article" dtd-version="1.2" xml:lang="ru" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"><front><journal-meta><journal-id journal-id-type="issn">2687-0940</journal-id><journal-title-group><journal-title>Challenges in modern medicine</journal-title></journal-title-group><issn pub-type="epub">2687-0940</issn></journal-meta><article-meta><article-id pub-id-type="doi">10.52575/2687-0940-2026-49-3-253-264</article-id><article-id pub-id-type="publisher-id">294</article-id><article-categories><subj-group subj-group-type="heading"><subject>INTERNAL DISEASES</subject></subj-group></article-categories><title-group><article-title>&lt;strong&gt;Features of the Pathogenetic Combination of Acute Coronary Syndrome and COVID-19 Infection in Elderly Patients&lt;/strong&gt;</article-title><trans-title-group xml:lang="en"><trans-title>&lt;strong&gt;Features of the Pathogenetic Combination of Acute Coronary Syndrome and COVID-19 Infection in Elderly Patients&lt;/strong&gt;</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author"><name-alternatives><name xml:lang="ru"><surname>Golubev</surname><given-names>Nikita V.</given-names></name><name xml:lang="en"><surname>Golubev</surname><given-names>Nikita V.</given-names></name></name-alternatives><email>nikvalgol@yandex.ru</email></contrib></contrib-group><pub-date pub-type="epub"><year>2026</year></pub-date><volume>49</volume><issue>3</issue><fpage>0</fpage><lpage>0</lpage><self-uri content-type="pdf" xlink:href="/media/journal-medicine/2026/3/Статья_-_АПМ_Том_49__3.pdf" /><abstract xml:lang="ru"><p>Abstract.&amp;nbsp;The pathogenetic combination of acute coronary syndrome (ACS) and coronavirus infection is unfavorable in terms of the development of complications and fatal outcomes. The aim of this study is to identify risk factors for the development of complications and unfavorable outcomes in patients with acute coronary syndrome and COVID‑19 infection, especially in the elderly. The paper presents a description of a study conducted at regional vascular centers in the Tula region. The author conducted a static analysis of patient medical records. After 1,500 days from the start of observation, the patients&amp;rsquo; survival was analyzed. The study has reliably established that the following factors are most important for predicting a fatal outcome after acute coronary syndrome in the context of COVID‑19 infection: age, presence of complications, creatine phosphokinase‑MB (CPK‑MB) levels on the second day after the onset of the disease, a left ventricular ejection fraction (LVEF) of less than 40 %, and triple anticoagulant (AC) therapy in the hospital (which indicates a high risk of thrombotic complications after coronary angiography). Based on the study results, a scheme for follow‑up monitoring of this group of patients has been implemented in practice.</p></abstract><trans-abstract xml:lang="en"><p>Abstract.&amp;nbsp;The pathogenetic combination of acute coronary syndrome (ACS) and coronavirus infection is unfavorable in terms of the development of complications and fatal outcomes. The aim of this study is to identify risk factors for the development of complications and unfavorable outcomes in patients with acute coronary syndrome and COVID‑19 infection, especially in the elderly. The paper presents a description of a study conducted at regional vascular centers in the Tula region. The author conducted a static analysis of patient medical records. After 1,500 days from the start of observation, the patients&amp;rsquo; survival was analyzed. The study has reliably established that the following factors are most important for predicting a fatal outcome after acute coronary syndrome in the context of COVID‑19 infection: age, presence of complications, creatine phosphokinase‑MB (CPK‑MB) levels on the second day after the onset of the disease, a left ventricular ejection fraction (LVEF) of less than 40 %, and triple anticoagulant (AC) therapy in the hospital (which indicates a high risk of thrombotic complications after coronary angiography). Based on the study results, a scheme for follow‑up monitoring of this group of patients has been implemented in practice.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>Keywords: acute coronary syndrome</kwd><kwd>coronavirus infection</kwd><kwd>COVID-19</kwd><kwd>coronary heart disease</kwd><kwd>myocardial infarction</kwd><kwd>old age</kwd></kwd-group><kwd-group xml:lang="en"><kwd>Keywords: acute coronary syndrome</kwd><kwd>coronavirus infection</kwd><kwd>COVID-19</kwd><kwd>coronary heart disease</kwd><kwd>myocardial infarction</kwd><kwd>old age</kwd></kwd-group></article-meta></front><back><ack><p>Funding: the work was carried out without external sources of funding.</p></ack><ref-list><title>Список литературы</title><ref id="B1"><mixed-citation>References</mixed-citation></ref><ref id="B2"><mixed-citation>Antoshkin O.N. 2021. Analysis of Complications from Coronavirus Infection COVID-19 According to Pathoanatomic Studies. 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