Pandemic effect on ischaemic burden and prehospital time in acute coronary syndrome

Background: Acute coronary syndrome (ACS) requires rapid identification and intervention. Early recognition of symptoms, detection of ischaemic markers in electrocardiograms (ECGs) and timely reperfusion therapy all reduce the total ischaemic time. In 2020, SARS-CoV-2 emerged as a new threat to people with cardiac disease: calls to emergency departments, emergency department visits and hospital admissions for acute cardiac conditions decreased, possibly because patients delayed seeking care because of fear of SARS-CoV-2 exposure. The hypothesis of this study was that patients presenting with ACS during the pandemic would have more ischaemic features and longer prehospital time intervals than those presenting before the pandemic. However, there were no significant differences between pre-pandemic and pandemic groups regarding incidence of ECG ischaemic markers, elevated troponin, adverse outcomes or prehospital time intervals. Non-ST-elevation myocardial infarction was significantly higher in the pandemic sample, which suggests that patients with less severe symptoms sought treatment during the pandemic.