Patient response, treatments, and mortality for acute myocardial infarction during the COVID-19 pandemic.
Eur Heart J Qual Care Clin Outcomes
; 7(3): 238-246, 2021 05 03.
Artículo
en Inglés
| MEDLINE | ID: covidwho-691280
ABSTRACT
AIMS:
COVID-19 might have affected the care and outcomes of hospitalized acute myocardial infarction (AMI). We aimed to determine whether the COVID-19 pandemic changed patient response, hospital treatment, and mortality from AMI. METHODS ANDRESULTS:
Admission was classified as non-ST-elevation myocardial infarction (NSTEMI) or STEMI at 99 hospitals in England through live feeding from the Myocardial Ischaemia National Audit Project between 1 January 2019 and 22 May 2020. Time series plots were estimated using a 7-day simple moving average, adjusted for seasonality. From 23 March 2020 (UK lockdown), median daily hospitalizations decreased more for NSTEMI [69 to 35; incidence risk ratios (IRR) 0.51, 95% confidence interval (CI) 0.47-0.54] than STEMI (35 to 25; IRR 0.74, 95% CI 0.69-0.80) to a nadir on 19 April 2020. During lockdown, patients were younger (mean age 68.7 vs. 66.9 years), less frequently diabetic (24.6% vs. 28.1%), or had cerebrovascular disease (7.0% vs. 8.6%). ST-elevation myocardial infarction more frequently received primary percutaneous coronary intervention (81.8% vs. 78.8%), thrombolysis was negligible (0.5% vs. 0.3%), median admission-to-coronary angiography duration for NSTEMI decreased (26.2 vs. 64.0 h), median duration of hospitalization decreased (4 to 2 days), secondary prevention pharmacotherapy prescription remained unchanged (each > 94.7%). Mortality at 30 days increased for NSTEMI [from 5.4% to 7.5%; odds ratio (OR) 1.41, 95% CI 1.08-1.80], but decreased for STEMI (from 10.2% to 7.7%; OR 0.73, 95% CI 0.54-0.97).CONCLUSION:
During COVID-19, there was a substantial decline in admissions with AMI. Those who presented to hospital were younger, less comorbid and, for NSTEMI, had higher 30-day mortality.Palabras clave
Texto completo:
Disponible
Colección:
Bases de datos internacionales
Base de datos:
MEDLINE
Asunto principal:
Infarto del Miocardio sin Elevación del ST
/
Infarto del Miocardio con Elevación del ST
/
COVID-19
Tipo de estudio:
Estudios diagnósticos
/
Estudio experimental
/
Estudio observacional
/
Estudio pronóstico
Tópicos:
Covid persistente
País/Región como asunto:
Europa
Idioma:
Inglés
Revista:
Eur Heart J Qual Care Clin Outcomes
Año:
2021
Tipo del documento:
Artículo
País de afiliación:
Ehjqcco
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