Key result
The COVID-19 pandemic period was associated with a significantly higher rate of major adverse cardiovascular events (29.7% vs 17.3%) in patients with acute myocardial infarction compared to the pre-pandemic period.
Why the study?
Treatment of AMI was affected during the COVID-19 pandemic, but its impact on the treatment and prognosis of rural and urban AMI in developing countries had not been explored.
Does the COVID-19 pandemic worsen treatment times and clinical outcomes in patients with acute myocardial infarction?
Observational (n=325)
No
Does the COVID-19 pandemic worsen treatment times and clinical outcomes in patients with acute myocardial infarction?
The COVID-19 pandemic was associated with delayed reperfusion times and significantly increased 1-year MACE and mortality in patients with acute myocardial infarction, particularly in rural areas.
Pandemic-era AMI care was associated with higher MACE; leaves open whether targeted system changes reduce risk in future outbreaks.
INTRODUCTION: The treatment of acute myocardial infarction (AMI) during the COVID-19 pandemic has been affected to varying degrees. This study is the first to explore the impact of COVID-19 on the treatment and prognosis of rural and urban AMI in developing countries. METHODOLOGY: A total of 128 patients with AMI in our hospital during the COVID-19 pandemic were enrolled. A total of 197 patients diagnosed with AMI before the COVID-19 pandemic were selected as the control group and one year of follow-up was performed. RESULTS: Hospital stay and the proportion of Killip class ≥ 2 patients were increased among rural AMI patients in the 'during COVID-19' group, compared with the 'before COVID-19' group. Among ST-segment elevation myocardial infarction (STEMI) total and rural STEMI patients, the treatment time in the during-COVID-19 group was longer than that in the before-COVID-19 group, whereas only the symptom to door (S to D) total and door to balloon (D to B) were extended in urban STEMI patients. In AMI total and rural AMI patients, major adverse cardiovascular events (MACEs) and all-cause mortality were increased in the during-COVID-19 group compared with the before-COVID-19 group. Kaplan-Meier analysis revealed that the survival and occurrence of MACEs in AMI total and rural AMI patients were significantly higher in the during-COVID-19 group. CONCLUSIONS: The COVID-19 pandemic led to delayed treatment and worse prognosis in AMI patients. Rural areas appear to be at a greater risk.
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Zhang et al. (2022) conducted an observational in Acute myocardial infarction (n=325). COVID-19 pandemic period vs. Before COVID-19 pandemic period was evaluated on Major adverse cardiovascular events (MACEs) (p=0.008). The COVID-19 pandemic period was associated with a significantly higher rate of major adverse cardiovascular events (29.7% vs 17.3%) in patients with acute myocardial infarction compared to the pre-pandemic period.
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