AI Article Synopsis

  • COVID-19 significantly impacted the healthcare system, leading to a decline in in-hospital admissions for acute myocardial infarction (AMI), but its effect on mechanical complications in ST-elevation myocardial infarction (STEMI) has not been thoroughly examined.
  • A study involving 479 STEMI patients showed a decrease in primary percutaneous coronary intervention (PCI) during the pandemic and longer symptom onset-to-door times, indicating delays in treatment.
  • Mechanical complications and in-hospital mortality for STEMI patients increased during the second wave of the pandemic, highlighting ongoing challenges despite previous healthcare adaptations.

Article Abstract

Aims: COVID-19 has dramatically impacted the healthcare system. Evidence from previous studies suggests a decline in in-hospital admissions for acute myocardial infarction (AMI) during the pandemic. However, the effect of the pandemic on mechanical complications (MC) in acute ST-segment elevation myocardial infarction (STEMI) has not been comprehensively investigated. Therefore, we evaluated the impact of the pandemic on MC and in-hospital outcomes in STEMI during the second wave, in which there was a huge SARS-CoV-2 diffusion in Italy.

Methods And Results: Based on a single center cohort of AMI patients admitted with STEMI between February 1, 2019, and February 28, 2021, we compared the characteristics and outcomes of STEMI patients treated during the pandemic vs. those treated before the pandemic. In total, 479 STEMI patients were included, of which 64.5% were during the pandemic. Relative to before the pandemic, primary percutaneous coronary intervention (PCI) declined (87.7 vs. 94.7%, = 0.014) during the pandemic. Compared to those admitted before the pandemic (10/2019 to 2/2020), STEMI patients admitted during the second wave (10/2020 to 2/2021) presented with a symptom onset-to-door time greater than 24 h (26.1 vs. 10.3%, = 0.009) and a reduction of primary PCI (85.2 vs. 97.1%, = 0.009). MC occurred more often in patients admitted during the second wave of the pandemic than in those admitted before the pandemic (7.0 vs. 0.0%, = 0.032). In-hospital mortality increased during the second wave (10.6 vs. 2.9%, = 0.058).

Conclusion: Although the experience gained during the first wave and a more advanced hub-and-spoke system for cardiovascular emergencies persists, late hospitalizations and a high incidence of mechanical complications in STEMI were observed even in the second wave.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9573996PMC
http://dx.doi.org/10.3389/fcvm.2022.950952DOI Listing

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