Suffering from acute coronary syndrome in the period following the first COVID-19 lockdown was associated with a significantly increased risk of in-hospital mortality compared to the same period in 2019 (HR 1.96).
Observational (n=5,421)
Yes
Does hospitalization for ACS during the post-first-wave COVID-19 pandemic period increase mortality risk compared to the pre-pandemic period?
The post-first-wave COVID-19 period was associated with a higher comorbidity burden and increased mortality risk among patients presenting with acute coronary syndrome.
Effect estimate: HR 1.96 (95% CI 1.04-3.70)
Absolute Event Rate: 2.7% vs 1.9%
p-value: p=0.04
BACKGROUND: The collateral damage caused by the COVID-19 pandemic affected cardiovascular disease patients, mainly acute coronary syndrome (ACS) cases. Additionally, lockdown caused treatment-related concerns and reluctance to seek medical help, factors that can delay treatment. AIM: We aimed to analyze the incidence and course of ACS after the first COVID-19 wave. METHODS: The report is based on a multi-institutional registry of 10 interventional cardiology departments. ACS patient data were gathered from June to October 2020, i.e. in the period following the first lockdown in Poland (March 30-May 31, 2020) and compared with the corresponding 2019 timeframe. RESULTS: Patients (2801 and 2620) hospitalized for ACS in 2019 and 2020 (June-October) represented 52.8% and 57.9% of coronary artery disease admissions, respectively. In 2020 vs. 2019, more cases of arterial hypertension (80.2% vs. 71.5%; P <0.001), diabetes (32.7% vs. 28.2%; P <0.001) hyperlipidemia (53.2% vs. 49.8%; P = 0.01), and smoking history (29.5% vs. 25.8%; P = 0.003) were detected. Median troponin and cholesterol values, as well as glycemia, were higher in 2020. Patients were more likely to undergo percutaneous treatment (91.2% vs. 87.5%; P <0.001) and were less often referred for surgery (3.7% vs. 4.9%; P = 0.03). No differences in deaths from repeat myocardial infarction, stroke, and/or composite endpoint (major adverse cardiac and cerebrovascular events MACCE) were noted. However, suffering from ACS in 2020 (June-October) was a risk factor for mortality based on multivariable analysis. CONCLUSIONS: The COVID-19 pandemic affected ACS patient profile, course of treatment, and increased risk for mortality.
Jankowska-Sanetra et al. (Tue,) conducted a observational in Acute coronary syndrome (n=5,421). Admission during post-lockdown period (June-October 2020) vs. Admission during corresponding timeframe in 2019 was evaluated on In-hospital mortality (HR 1.96, 95% CI 1.04-3.70, p=0.04). Suffering from acute coronary syndrome in the period following the first COVID-19 lockdown was associated with a significantly increased risk of in-hospital mortality compared to the same period in 2019 (HR 1.96).