The COVID-19 pandemic period was associated with significantly higher 30-day overall mortality (19.8% vs 1.4%) among patients with acute myocardial infarction compared to a historical cohort.
Case-Control (n=391)
No
Does the COVID-19 pandemic worsen clinical presentation, treatment times, and 30-day mortality in patients with acute myocardial infarction?
The COVID-19 pandemic was associated with significant delays in reperfusion therapy, more severe clinical presentations, and increased 30-day mortality among patients with acute myocardial infarction.
Absolute Event Rate: 19.8% vs 1.4%
p-value: p=<0.01
Background The coronavirus disease (COVID-19) pandemic affected the prompt diagnosis and treatment of Acute myocardial infarction (AMI). AIM: To characterize the clinical profile of patients with AMI during the COVID-19 pandemic, comparing them with a historical cohort. MATERIAL AND METHODS: A case-control study of 96 patients with AMI transferred to a high-volume percutaneous coronary intervention (PCI) hospital between March and July 2020, and a historical cohort of 269 patients transferred during the same period in 2019. RESULTS: When comparing patients transferred during the pandemic with those of the historical cohort, the former were younger (63 ± 12 vs 68 ± 12 years, p 12 hours from the onset of symptoms (44 vs 0%, p < 0.01), a higher median door-to-device time (4 vs 3 hours, p < 0.01), a higher use of primary percutaneous coronary intervention (97 vs 71%, p < 0.01), and higher frequencies of cardiogenic shock (20 vs 4%, p < 0.01) and mechanical complications (10% vs 2%, p < 0.01). Patients during COVID pandemic had a higher thirty-day overall (20 vs 1.4%, p < 0.01) and cardiovascular mortality (13 vs 1%, p < 0.01). During the outbreak, 40% of patients had positive COVID-19 status, which was a predictor for thirty-day overall mortality (Risk ratio 2.90; 95% confidence intervals 1.14-7.36). CONCLUSIONS: During the pandemic patients with AMI exhibited delays in consultations and treatment, higher morbidity, and increased mortality. COVID-19 positivity was associated to worse thirty-day overall survival.
Cataldo et al. (Sat,) conducted a case-control in Acute myocardial infarction (AMI) (n=391). COVID-19 pandemic period vs. Historical cohort (2019) was evaluated on Thirty-day overall mortality (p=<0.01). The COVID-19 pandemic period was associated with significantly higher 30-day overall mortality (19.8% vs 1.4%) among patients with acute myocardial infarction compared to a historical cohort.