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Acute Coronary Syndrome in the COVID-19 Pandemic: Reduced Cases and Increased Ischaemic Time.
Sutherland, Nigel; Dayawansa, Nalin H; Filipopoulos, Benjamin; Vasanthakumar, Sheran; Narayan, Om; Ponnuthurai, Francis A; van Gaal, William.
  • Sutherland N; Department of Cardiology, Northern Health, Melbourne, Vic, Australia. Electronic address: nigel.sutherland@nh.org.au.
  • Dayawansa NH; Department of Cardiology, Northern Health, Melbourne, Vic, Australia.
  • Filipopoulos B; Department of Medicine, Northern Health, Melbourne, Vic, Australia.
  • Vasanthakumar S; Department of Cardiology, Northern Health, Melbourne, Vic, Australia.
  • Narayan O; Department of Cardiology, Northern Health, Melbourne, Vic, Australia.
  • Ponnuthurai FA; Department of Cardiology, Northern Health, Melbourne, Vic, Australia.
  • van Gaal W; Department of Cardiology, Northern Health, Melbourne, Vic, Australia; Department of Medicine, University of Melbourne, Melbourne, Vic, Australia.
Heart Lung Circ ; 31(1): 69-76, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1370529
ABSTRACT

BACKGROUND:

The COVID-19 pandemic has led to unprecedented stress on health care systems, and has affected acute coronary syndrome treatment at every step. This study aimed to examine the impact of COVID-19 on patient presentations with acute coronary syndromes during the first and second pandemic wave in Melbourne, Victoria.

METHOD:

A retrospective cohort study of adults presenting with cute coronary syndrome during the first pandemic wave from 1 March 2020 to 31 April 2020 and the second pandemic wave from 1 July 2020 to 31 August 2020 was compared to a control period from 1 March to 31 April 2019 at a single sub-tertiary referral centre in Melbourne, Victoria servicing a catchment area with a relatively high incidence of COVID-19 cases.

RESULTS:

Three-hundred-and-thirty-five (335) patients were hospitalised with acute coronary syndromes across all three time periods. The total number of patients presenting with an acute coronary syndrome was reduced during the pandemic, with a higher proportion of ST elevation myocardial infarctions. Ischaemic times increased with time from symptom onset to first medical contact rising from 191 minutes in the control period to 292 minutes in the first wave (p=0.06) and 271 minutes in the second wave (p=0.06). Coronary angiography with subsequent revascularisation significantly increased from 55% in the control period undergoing revascularisation to 69% in the first wave (p<0.001) and 74% in the second wave (p<0.001).

CONCLUSION:

A concerning reduction in acute coronary presentations occurred during the COVID-19 pandemic, associated with longer ischaemic times and a higher proportion requiring revascularisation. It is crucial that public awareness campaigns are instituted to address the contributing patient factors in future waves.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Acute Coronary Syndrome / COVID-19 Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study Topics: Long Covid Limits: Humans Language: English Journal: Heart Lung Circ Journal subject: Vascular Diseases / Cardiology Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Acute Coronary Syndrome / COVID-19 Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study Topics: Long Covid Limits: Humans Language: English Journal: Heart Lung Circ Journal subject: Vascular Diseases / Cardiology Year: 2022 Document Type: Article