Key result
COVID-19 infection did not significantly affect in-hospital mortality among patients with acute myocardial infarction compared to COVID-negative patients (1.9% vs 1.4%, p=0.799).
Why the study?
The impacts of COVID-19 on acute myocardial infarction care were heterogeneous, prompting an analysis of clinical characteristics and outcomes across different pandemic stages in China.
Does COVID-19 infection or pandemic period affect in-hospital mortality, reperfusion times, and clinical outcomes in patients with acute myocardial infarction?
Cohort (n=1,021)
Yes
Does COVID-19 infection or pandemic period affect in-hospital mortality, reperfusion times, and clinical outcomes in patients with acute myocardial infarction?
While in-hospital mortality for AMI remained stable across pandemic periods, COVID-19 infection was associated with longer reperfusion times and a higher risk of left ventricular systolic dysfunction.
Should not yet change AMI mortality expectations by pandemic phase; leaves open whether COVID-linked delays drive later LVSD or events.
BACKGROUND: The impacts of COVID-19 on acute myocardial infarction (AMI) care were heterogeneous. The study aims to analyze the clinical characteristics and outcomes of AMI patients in China during different stages of the COVID-19 pandemic. METHODS: This is a multicenter retrospective cohort study in Shanxi Province of northern China. Patients diagnosed with AMI during the zero-case, lockdown, and outbreak periods were included. Characteristics and outcomes were analyzed according to time periods and COVID-19 infection. The primary outcome was in-hospital mortality. Additional outcomes included reperfusion times, coronary angiographic measures, procedure or AMI-associated complications, arrhythmia, other adverse events, and left ventricular systolic dysfunction (LVSD). RESULTS: The study included 1021 AMI patients, with 393, 250, and 378 from the zero-case, lockdown, and outbreak periods. No differences in in-hospital mortality or other adverse events were found by time periods. By infection status, 264 patients were COVID-positive, and 706 were COVID-negative. The COVID-positive ST-elevation myocardial infarction population had longer symptom-to-first medical contact (3.07 vs. 2.31, p = 0.026), pre-hospital time (4.58 vs. 3.67, p = 0.032), door-to-balloon (1.20 vs. 1.08, p = 0.046), and total ischemic time (5.80 vs. 4.70, p = 0.011). No differences in other in-hospital outcomes were found, except that multivariate logistic regression analysis demonstrated COVID-19 infection was correlated with increased risks of LVSD (OR 1.73, 95% CI 1.11-2.69, p = 0.015). CONCLUSIONS: In-hospital mortality did not differ by time period or COVID-19 infection status. The COVID-positive AMI patients had longer reperfusion times and higher risks of LVSD. AMI treatments were impacted during the pandemic, and measures are warranted to minimize the reperfusion time.
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Li et al. (2025) conducted a cohort in Acute myocardial infarction (n=1,021). COVID-19 infection vs. COVID-19 negative was evaluated on In-hospital mortality (p=0.799). COVID-19 infection did not significantly affect in-hospital mortality among patients with acute myocardial infarction compared to COVID-negative patients (1.9% vs 1.4%, p=0.799).
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