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Consequences of COVID-19 pandemic on myocardial infarction reperfusion therapy and prognosis / Consecuencias de la pandemia COVID-19 en la reperfusión y pronóstico del infarto de miocardio
Cataldo, Pabla; Verdugo, Fernando J; Bonta, Camila; Dauvergne, Christian; García, Alfonso; Méndez, Manuel; Uriarte, Polentzi; Pineda, Fernando; Duarte, Manuel; Sued, Raúl; Fuica, Pablo; Torres, Gonzalo; Sandoval, Jorge.
  • Cataldo, Pabla; Instituto Nacional del Tórax. Department of Cardiology. Santiago. CL
  • Verdugo, Fernando J; Hospital Militar de Santiago. Department of Cardiology. Santiago. CL
  • Bonta, Camila; Hospital Militar de Santiago. Department of Cardiology. Santiago. CL
  • Dauvergne, Christian; Instituto Nacional del Tórax. Department of Cardiology. Santiago. CL
  • García, Alfonso; Universidad de Chile. Department of Internal Medicine. Santiago. CL
  • Méndez, Manuel; Instituto Nacional del Tórax. Department of Cardiology. Santiago. CL
  • Uriarte, Polentzi; Instituto Nacional del Tórax. Department of Cardiology. Santiago. CL
  • Pineda, Fernando; Instituto Nacional del Tórax. Department of Cardiology. Santiago. CL
  • Duarte, Manuel; Hospital Dr Luis Tisné Brousse. Department of Cardiology. Santiago. CL
  • Sued, Raúl; Hospital Dr Luis Tisné Brousse. Department of Cardiology. Santiago. CL
  • Fuica, Pablo; Hospital del Salvador. Department of Cardiology. Santiago. CL
  • Torres, Gonzalo; Hospital del Salvador. Department of Cardiology. Santiago. CL
  • Sandoval, Jorge; Instituto Nacional del Tórax. Department of Cardiology. Santiago. CL
Rev. méd. Chile ; 149(5): 672-681, mayo 2021. tab, graf
Article in English | LILACS | ID: biblio-1389516
ABSTRACT
ABSTRACT Background The coronavirus disease (COVID-19) pandemic affected the prompt diagnosis and treatment of Acute myocardial infarction (AMI).

Aim:

To characterize the clinical profile of patients with AMI during the COVID-19 pandemic, comparing them with a historical cohort. Material and

Methods:

A case-control study of 96 patients with AMI transferred to a high-volume percutaneous coronary intervention (PCI) hospital between March and July 2020, and a historical cohort of 269 patients transferred during the same period in 2019.

Results:

When comparing patients transferred during the pandemic with those of the historical cohort, the former were younger (63 ± 12 vs 68 ± 12 years, p 12 hours from the onset of symptoms (44 vs 0%, p < 0.01), a higher median door-to-device time (4 vs 3 hours, p < 0.01), a higher use of primary percutaneous coronary intervention (97 vs 71%, p < 0.01), and higher frequencies of cardiogenic shock (20 vs 4%, p < 0.01) and mechanical complications (10% vs 2%, p < 0.01). Patients during COVID pandemic had a higher thirty-day overall (20 vs 1.4%, p < 0.01) and cardiovascular mortality (13 vs 1%, p < 0.01). During the outbreak, 40% of patients had positive COVID-19 status, which was a predictor for thirty-day overall mortality (Risk ratio 2.90; 95% confidence intervals 1.14-7.36).

Conclusions:

During the pandemic patients with AMI exhibited delays in consultations and treatment, higher morbidity, and increased mortality. COVID-19 positivity was associated to worse thirty-day overall survival.
RESUMEN
Antecedentes La pandemia COVID-19 afectó el tratamiento oportuno del infarto agudo de miocardio (IAM).

Objetivo:

Caracterizar el perfil clínico de pacientes con IAM durante la pandemia COVID-19 y compararlos con una cohorte histórica. Pacientes y

Métodos:

Estudio caso-control de 96 pacientes con IAM transferidos a un hospital de alto volumen de intervención coronaria percutánea (ICP) entre marzo julio de 2020 y una cohorte histórica de 269 pacientes transferidos en el mismo período de 2019 (n = 269).

Resultados:

Al comparar los pacientes transferidos durante pandemia y la cohorte histórica, los primeros eran más jóvenes (63 ± 12 y 68 ± 12 años respectivamente, p 12 h desde iniciados síntomas de IAM con elevación ST (44,4 y 0% respectivamente, p < 0,01), una mediana de tiempo puerta-guía mayor (4 y 3 horas respectivamente, p < 0,01), un mayor uso de ICP primaria (97 y 71% respectivamente, p < 0,01), mayor frecuencia de shock cardiogénico (19,8 y 4,1% respectivamente, p < 0.01) y complicaciones mecánicas (10,4 y 1,7% respectivamente, p < 0,01). A treinta días, los primeros tuvieron mayor mortalidad general (19,8 y 1,4% respectivamente p < 0.01) y cardiovascular (12,5 y 1,4% respectivamente, p < 0,01). Durante la pandemia, 40% de los pacientes presentó positividad para COVID-19, siendo un factor predictivo de mortalidad general (razón de riesgo 2,90; intervalos de confianza 95% 1,14-7,36).

Conclusiones:

Durante la pandemia, hubo retrasos en tiempos de consulta y tratamiento y mayor morbimortalidad del IAM. La positividad de COVID-19 se asoció a peor sobrevida general a treinta días.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Angioplasty, Balloon, Coronary / Percutaneous Coronary Intervention / COVID-19 / Myocardial Infarction Type of study: Practice guideline / Observational study / Prognostic study / Risk factors / Screening study Limits: Humans Language: English Journal: Rev. méd. Chile Journal subject: Medicine Year: 2021 Type: Article Affiliation country: Chile Institution/Affiliation country: Hospital Dr Luis Tisné Brousse/CL / Hospital Militar de Santiago/CL / Hospital del Salvador/CL / Instituto Nacional del Tórax/CL / Universidad de Chile/CL

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Full text: Available Index: LILACS (Americas) Main subject: Angioplasty, Balloon, Coronary / Percutaneous Coronary Intervention / COVID-19 / Myocardial Infarction Type of study: Practice guideline / Observational study / Prognostic study / Risk factors / Screening study Limits: Humans Language: English Journal: Rev. méd. Chile Journal subject: Medicine Year: 2021 Type: Article Affiliation country: Chile Institution/Affiliation country: Hospital Dr Luis Tisné Brousse/CL / Hospital Militar de Santiago/CL / Hospital del Salvador/CL / Instituto Nacional del Tórax/CL / Universidad de Chile/CL