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Background/study objective: The effect of the COVID-19 pandemic affected health care delivery, as it led to variable outcomes in different disease states including cardiovascular diseases. In this study, we evaluated the impact of coexisting COVID-19 on Acute Myocardial Infarction (AMI). Design/setting: We analyzed discharge records of AMI patients from the National Inpatient Sample (NIS) in the year 2020. Main outcome measures: Using propensity score matching, we assessed the impact of COVID-19 infection on the in-hospital outcomes of patients presenting with AMI. Results: There were 1154 patients with concomitant COVID-19 infection and AMI who were matched with 109,990 patients with AMI and without COVID-19. We found that patients with COVID-19 who had AMI were less likely to have dyslipidemia (64.6 % vs. 70.4 %, p < 0.001), peripheral vascular disease (2.4 % vs. 3.8 % p = 0.0017), smoking history (23.5 % vs. 28.2 % p < 0.0001) and hypertension (37.1 % vs. 40.1 % p = 0.004).COVID-19 was associated with higher hospital mortality rates (Adjusted odds ratio aOR: 2.72, CI: 2.23-3.30, p < 0.001), cardiac arrest (aOR: 1.65, 95 % CI: 1.26-2.15, p < 0.001), cardiogenic shock (aOR:1.36,95 % CI: 1.10-1.68, p = 0.004) and respiratory failure (aOR:1.81, 95 % CI: 1.55-2.11 p < 0.001) compared to AMI patients without COVID-19. There was also a significant association between coexisting COVID-19 and longer duration of hospital stay (Adjusted mean differences:1.40, 95 % CI: 1.31-1.59 p < 0.0001) in AMI patients. Conclusion: COVID-19 infection is associated with worse in-hospital mortality and cardiorespiratory complications in patients with AMI.
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Background The COVID-19 pandemic prompted a major surge in telehealth practices, including the increased utilization of remote Pulmonary Artery Pressure (PAP) among cardiologists worldwide. This study aimed to assess the sociodemographic differences in the utilization of the CardioMEMS HF system for remote PAP monitoring in patients with Heart Failure in the USA. Methods The National inpatient sample database of the USA was queried for all patients with HF who received the CardioMEMS HF system between 2016 and 2019. Multiple logistic regression models were subsequently performed to investigate the socio-demographic factors influencing remote pulmonary artery pressure measurements. Results A total of 1540 patients had a CardioMEMS device for remote PAP monitoring between 2016 and 2019. Following a multivariate analysis accounting for potential confounders, we noted that the use of remote PAP was lower in women vs. men (Adjusted odds ratio (AOR): 0.65, CI 0.52 - 0.82, p < 0.001). Patients who lived in low (AOR: 0.38, CI 0.25 - 0.57, p < 0.001), medium (AOR: 0.57, CI 0.40 - 0.82, p = 0.003), and high-income neighborhoods (AOR: 0.60, CI 0.44 - 0.82, p < 0.001), were also less likely to have remote PAP compared to patients who lived in very high-income neighborhoods. There was no racial difference or association between device use and primary insurance payer. Conclusion There are inequities in the utilization of remote PAP monitoring amongst the Heart Failure population within the USA.Copyright © 2023 American College of Cardiology Foundation