Changes in the characteristics of patients with acute myocardial infarction during wartime in Ukraine

Objective To determine the demographic, anamnestic, clinical, and functional characteristics of patients hospitalized in a specialized department in 2024 compared to 2021. Materials and methods A retrospective analysis of medical records of patients hospitalized with AMI in 2021 (n=584) and 2024 (n=922) was performed. All patients were urgently hospitalized in the specialized cardiology department of the Vinnytsia Regional Center for Cardiovascular Pathology. The data on medical history, coronary angiography (CAG) results, and complications of AMI were evaluated. A comparison of data before (2021) and after (2024) the start of full-scale military operations was performed. Results The total number of patients with AMI increased from 584 in 2021 to 922 in 2024. The proportion of men decreased from 69.7% to 65.1% (p=0.044). The incidence of CAG remained high and did not change significantly over the comparison years: 87% in 2021 and 90.7% in 2024, respectively. Most patients had primary MI, namely 88.2% in 2021 and 90.5% in 2024. The results of CAG revealed changes, namely, the frequency of single-vessel disease decreased from 50. 2% to 29.2%, p<0.001, and multivessel disease became significantly more common - 15.9% in 2021 and 42.4% in 2024, p<0.001. The localization of MI also changed: the frequency of MI of the lateral wall of the LV increased (from 2.9% to 19.8%, p<0.001), and the frequency of circular MI decreased from 3.1% to 1.1%, p=0.034. The frequency of concomitant diabetes mellitus and arterial hypertension increased significantly, namely DM from 18.1% in 2021 to 22.9% in 2024 (p=0.02), AH from 90.6% to 99% (p=0.001), respectively. Survival rates remained high and even showed an upward trend (87.7% and 90.9%, respectively). The main complications of MI in 2021 and 2024 were consistently pulmonary edema (21 cases (9%) and 42 (4.6%), respectively, p=0.44), cardiogenic shock (50 (8.6%) and 75 (8.1%), respectively, p=0.77), and ventricular fibrillation (25 (4.3%) in 2021 versus 41 (4.4%) in 2024, p=0.97). The incidence of complete AV block in 2024 decreased compared to 2021—25 (2.7%) versus 33 (5.6%), respectively (p=0.021). Conclusions During 2021–2024, there was an increase in the number of hospitalized patients with MI, an increase in the incidence of diabetes mellitus and hypertension in hospitalized patients, a change in the structure of coronary artery disease, and an increase in multivessel disease. Patient survival remained high, indicating the effectiveness of modern drug and interventional therapy even in wartime conditions. The data emphasize the need for continuous monitoring of demographic and clinical changes in patients with AMI to optimize treatment and prevent complications.