ABSTRACT
Background: ST-elevation myocardial infarction (STEMI) is characterized by acute coronary artery occlusion warranting emergent intervention. We aim to investigate the incidence, patient characteristics, hospital course and outcomes of STEMI patients as the pandemic continues to evolve. Method(s): STEMI alert data was obtained from an institutional database from 2009 to 2022. Patient characteristics, outcomes, and hospital course were obtained via chart review. True STEMI was determined by classic clinical presentation, ST elevation on EKG, troponin elevation, and acute vessel occlusion on coronary angiogram. We defined the pre-pandemic time frame as prior to 3/18/2020 (n=1002), and pandemic activations from 3/19/2020 - 10/2022 (n=113). Result(s): True STEMI incidence was significantly higher during the pandemic when compared to the pre-pandemic period (85.9% vs. 52.6%;p<0.05). 30- and 90-day mortality rate was significantly higher during the COVID-19 pandemic (12.1% vs. 6.8%;p<0.05 and 15.5 vs. 8.0%;p=0.01). There was a higher use of temporary mechanical support use in STEMI patients during the pandemic (19.5% vs. 10.3%;p=0.003). Interestingly, despite a higher percentage of true STEMIs and higher mortality rate during the pandemic, initial troponin (7.8 vs. 17.46;p=0.09) and peak troponin (18.1 vs. 52.8;p<0.001) were significantly lower. Conclusion(s): STEMI activations dipped during the pandemic and are still below pre-pandemic levels. During the pandemic, there were higher rates of true STEMIs, utilization of temporary mechanical support, and complicated hospitalizations with higher mortality. Despite poorer outcomes and complicated hospital course, patients presenting during the pandemic had lower initial and peak troponin levels, possibly indicating delayed presentation. [Formula presented]Copyright © 2023