Impact of the COVID-19 pandemic on the incidence and prognosis of acute myocardial infarction - a single-center restrospective analysis
Introduction: COVID-19 pandemic has led to a signifi cant change in the incidence and prognosis of acute myocardial infarction (AMI) by indirect and direct mechanisms. Aim: To assess the impact of the COVID-19 pandemic on the incidence and prognosis of AMI. Material and methods: We performed a retro...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | Bulgarian |
| Published: |
Pensoft Publishers
2023-04-01
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| Series: | Българска кардиология |
| Subjects: | |
| Online Access: | https://journal.bgcardio.org/article/98397/download/pdf/ |
| _version_ | 1797421001749823488 |
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| author | E. Dimitrova E. Trendafilova S. Nateva S. Georgieva E. Kostova G. Hristova A. Alexandrov H. Mateev G. Vladimirov |
| author_facet | E. Dimitrova E. Trendafilova S. Nateva S. Georgieva E. Kostova G. Hristova A. Alexandrov H. Mateev G. Vladimirov |
| author_sort | E. Dimitrova |
| collection | DOAJ |
| description | Introduction: COVID-19 pandemic has led to a signifi cant change in the incidence and prognosis of acute myocardial infarction (AMI) by indirect and direct mechanisms. Aim: To assess the impact of the COVID-19 pandemic on the incidence and prognosis of AMI. Material and methods: We performed a retrospective analysis of consecutive patients with AMI (STEMI and NSTEMI) during two time periods – the complete lockdown in Bulgaria and one of the waves of the pandemic. We compared patients’ risk profi le, index event, investigations and treatment to a control group from the pre-pandemic period. Results: During the fi rst period we included 52 patients with AMI without COVID-19 and compared them to a control group of 66 patients. We found a decrease primarily in the number of patients with STEMI. The scores for assessing diseaseseverity (GRACE, APACHE II, SOFA) were higher in 2020 compared to the pre-pandemic period. More patients presented with acute congestive heart failure, mortality was similar. During the second period we included 83 patients, 21 of them with COVID-19 infection. System delay was increased in all patients. Disease severity scores and baseline troponin were higher especially in the COVID-19 group. In-hospital mortality was substantially higher in patients with COVID-19 compared to controls (23,8% versus 9%, р = 0,0375), probably due to increased incidence of cardiogenic shock and need for mechanical ventilation. Conclusion: During the complete lockdown there was a reduction in the number of patients admitted with AMI, higher incidence of acute congestive heart failure and similar mortality. During one of the waves of the pandemic we found a signifi cant increase in system delay, not exceeding the recommended time frame of 120 minutes, and in disease severity in all patients. Concomitant COVID-19 infection was associated with higher in-hospital mortality due to increased incidence of cardiogenic shock and need for mechanical ventilation. |
| first_indexed | 2024-03-09T07:09:43Z |
| format | Article |
| id | doaj.art-c37dddf7b16c4447b69589ee9145f239 |
| institution | Directory Open Access Journal |
| issn | 2683-1015 |
| language | Bulgarian |
| last_indexed | 2024-03-09T07:09:43Z |
| publishDate | 2023-04-01 |
| publisher | Pensoft Publishers |
| record_format | Article |
| series | Българска кардиология |
| spelling | doaj.art-c37dddf7b16c4447b69589ee9145f2392023-12-03T09:13:26ZbulPensoft PublishersБългарска кардиология2683-10152023-04-01291506410.3897/bgcardio.29.e9839798397Impact of the COVID-19 pandemic on the incidence and prognosis of acute myocardial infarction - a single-center restrospective analysisE. Dimitrova0E. Trendafilova1S. Nateva2S. Georgieva3E. Kostova4G. Hristova5A. Alexandrov6H. Mateev7G. Vladimirov8National Heart Hospital – SofiaNational Heart Hospital – SofiaNational Heart Hospital – SofiaNational Heart Hospital – SofiaNational Heart Hospital – SofiaNational Heart Hospital – SofiaNational Heart Hospital – SofiaNational Heart Hospital – SofiaNational Heart Hospital – SofiaIntroduction: COVID-19 pandemic has led to a signifi cant change in the incidence and prognosis of acute myocardial infarction (AMI) by indirect and direct mechanisms. Aim: To assess the impact of the COVID-19 pandemic on the incidence and prognosis of AMI. Material and methods: We performed a retrospective analysis of consecutive patients with AMI (STEMI and NSTEMI) during two time periods – the complete lockdown in Bulgaria and one of the waves of the pandemic. We compared patients’ risk profi le, index event, investigations and treatment to a control group from the pre-pandemic period. Results: During the fi rst period we included 52 patients with AMI without COVID-19 and compared them to a control group of 66 patients. We found a decrease primarily in the number of patients with STEMI. The scores for assessing diseaseseverity (GRACE, APACHE II, SOFA) were higher in 2020 compared to the pre-pandemic period. More patients presented with acute congestive heart failure, mortality was similar. During the second period we included 83 patients, 21 of them with COVID-19 infection. System delay was increased in all patients. Disease severity scores and baseline troponin were higher especially in the COVID-19 group. In-hospital mortality was substantially higher in patients with COVID-19 compared to controls (23,8% versus 9%, р = 0,0375), probably due to increased incidence of cardiogenic shock and need for mechanical ventilation. Conclusion: During the complete lockdown there was a reduction in the number of patients admitted with AMI, higher incidence of acute congestive heart failure and similar mortality. During one of the waves of the pandemic we found a signifi cant increase in system delay, not exceeding the recommended time frame of 120 minutes, and in disease severity in all patients. Concomitant COVID-19 infection was associated with higher in-hospital mortality due to increased incidence of cardiogenic shock and need for mechanical ventilation.https://journal.bgcardio.org/article/98397/download/pdf/SARS-CoV-2COVID-19pandemicacute myocardial i |
| spellingShingle | E. Dimitrova E. Trendafilova S. Nateva S. Georgieva E. Kostova G. Hristova A. Alexandrov H. Mateev G. Vladimirov Impact of the COVID-19 pandemic on the incidence and prognosis of acute myocardial infarction - a single-center restrospective analysis Българска кардиология SARS-CoV-2 COVID-19 pandemic acute myocardial i |
| title | Impact of the COVID-19 pandemic on the incidence and prognosis of acute myocardial infarction - a single-center restrospective analysis |
| title_full | Impact of the COVID-19 pandemic on the incidence and prognosis of acute myocardial infarction - a single-center restrospective analysis |
| title_fullStr | Impact of the COVID-19 pandemic on the incidence and prognosis of acute myocardial infarction - a single-center restrospective analysis |
| title_full_unstemmed | Impact of the COVID-19 pandemic on the incidence and prognosis of acute myocardial infarction - a single-center restrospective analysis |
| title_short | Impact of the COVID-19 pandemic on the incidence and prognosis of acute myocardial infarction - a single-center restrospective analysis |
| title_sort | impact of the covid 19 pandemic on the incidence and prognosis of acute myocardial infarction a single center restrospective analysis |
| topic | SARS-CoV-2 COVID-19 pandemic acute myocardial i |
| url | https://journal.bgcardio.org/article/98397/download/pdf/ |
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