TITLE:
Delay Times and Clinical Outcomes in Acute Myocardial Infarction: Comparison of Periods before and during the COVID-19 Pandemic—Myocardial Infarction and the Pandemic
AUTHORS:
Clarice Teixeira Silva Araújo, Arnon Salviato Mameri, Thúlio Carrera Guarçoni Venturini, Marcus Tadeu Aguilar Constantino Matos, Igor Morais Araujo Lopes, Luiz Gustavo Ribeiro de Carvalho Murad, Cleberson Duartes Ovani, Guilherme Vassalo Morais, Fernanda Venturini de Castro, Danielle Lopes Rocha, Lucas Crespo de Barros, Rodolfo Costa Sylvestre, Luiz Fernando Machado Barbosa, Roberto Ramos Barbosa
KEYWORDS:
Myocardial Infarction, Primary Percutaneous Coronary Intervention, Coronary Reperfusion, Pandemic, COVID-19
JOURNAL NAME:
World Journal of Cardiovascular Diseases,
Vol.14 No.6,
June
27,
2024
ABSTRACT: Introduction: At the beginning of the COVID-19 pandemic, a drop in the number of patients treated for cardiac emergencies raised concern about cardiovascular mortality in that period. An increase in care delay for patients with ST-segment elevation myocardial infarction (STEMI) may have affected clinical outcomes. Objectives: To analyze delay times and clinical outcomes of patients with STEMI undergoing primary percutaneous coronary intervention (PPCI), before and during the COVID-19 pandemic. Methods: Retrospective observational study that included patients with STEMI undergoing PPCI from December 2018 to July 2021. The COVID-19 pandemic cases were divided into two groups: pandemic I—from March to August 2020; and pandemic II—from September 2020 to July 2021. Patients were compared according to the period of hospitalization. Primary outcomes were delay times in assistance and clinical outcomes (acute kidney injury [AKI], post-procedural vascular complications and in-hospital mortality). Results: 108 patients were included, 39 (36.1%) in the pre-pandemic period, 13 (12.1%) in pandemic I and 56 (51.8%) in pandemic II. Time from onset of symptoms to arrival at the service and door-to-balloon time did not differ significantly among groups. Vascular complications were more frequent during the pandemic (I and II) than in the pre-pandemic period (2.5% pre-pandemic vs 15.4% pandemic vs 12.5% pandemic II; p = 0.03). AKI incidence was similar in all three periods. There was a non-significant increase in in-hospital mortality during the COVID-19 pandemic. Conclusion: In patients with STEMI, there was an increase in vascular complications and a trend toward increased mortality during the COVID-19 pandemic. Delay times to admission and reperfusion did not differ significantly between before and during the pandemic.