Reconsidering treatment guidelines for acute myocardial infarction during the COVID-19 pandemic
Abstract Background COVID-19 affects healthcare resource allocation, which could lead to treatment delay and poor outcomes in patients with acute myocardial infarction (AMI). We assessed the impact of the COVID-19 pandemic on AMI outcomes. Methods We compared outcomes of patients admitted for acute...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-04-01
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| Series: | BMC Cardiovascular Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12872-022-02626-5 |
| _version_ | 1828370835246678016 |
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| author | Jing Gao Peng-Ju Lu Chang-Ping Li Hui Wang Ji-Xiang Wang Nan Zhang Xiao-Wei Li Hai-Wang Zhao Jing Dou Miao-Na Bai Yu-Tian Shi Jia Zhao Chun Zan Yin Liu |
| author_facet | Jing Gao Peng-Ju Lu Chang-Ping Li Hui Wang Ji-Xiang Wang Nan Zhang Xiao-Wei Li Hai-Wang Zhao Jing Dou Miao-Na Bai Yu-Tian Shi Jia Zhao Chun Zan Yin Liu |
| author_sort | Jing Gao |
| collection | DOAJ |
| description | Abstract Background COVID-19 affects healthcare resource allocation, which could lead to treatment delay and poor outcomes in patients with acute myocardial infarction (AMI). We assessed the impact of the COVID-19 pandemic on AMI outcomes. Methods We compared outcomes of patients admitted for acute ST-elevation MI (STEMI) and non-STEMI (NSTEMI) during a non-COVID-19 pandemic period (January–February 2019; Group 1, n = 254) and a COVID-19 pandemic period (January–February 2020; Group 2, n = 124). Results For STEMI patients, the median of first medical contact (FMC) time, door-to-balloon time, and total myocardial ischemia time were significantly longer in Group 2 patients (all p < 0.05). Primary percutaneous intervention was performed significantly more often in Group 1 patients than in Group 2 patients, whereas thrombolytic therapy was used significantly more often in Group 2 patients than in Group 1 patients (all p < 0.05). However, the rates of and all-cause 30-day mortality and major adverse cardiac event (MACE) were not significantly different in the two periods (all p > 0.05). For NSTEMI patients, Group 2 patients had a higher rate of conservative therapy, a lower rate of reperfusion therapy, and longer FMC times (all p < 0.05). All-cause 30-day mortality and MACE were only higher in NSTEMI patients during the COVID-19 pandemic period (p < 0.001). Conclusions COVID-19 pandemic causes treatment delay in AMI patients and potentially leads to poor clinical outcome in NSTEMI patients. Thrombolytic therapy should be initiated without delay for STEMI when coronary intervention is not readily available; for NSTEMI patients, outcomes of invasive reperfusion were better than medical treatment. |
| first_indexed | 2024-04-14T06:42:25Z |
| format | Article |
| id | doaj.art-d8666938e5504d4fbf100a628f107f34 |
| institution | Directory Open Access Journal |
| issn | 1471-2261 |
| language | English |
| last_indexed | 2024-04-14T06:42:25Z |
| publishDate | 2022-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cardiovascular Disorders |
| spelling | doaj.art-d8666938e5504d4fbf100a628f107f342022-12-22T02:07:17ZengBMCBMC Cardiovascular Disorders1471-22612022-04-0122111010.1186/s12872-022-02626-5Reconsidering treatment guidelines for acute myocardial infarction during the COVID-19 pandemicJing Gao0Peng-Ju Lu1Chang-Ping Li2Hui Wang3Ji-Xiang Wang4Nan Zhang5Xiao-Wei Li6Hai-Wang Zhao7Jing Dou8Miao-Na Bai9Yu-Tian Shi10Jia Zhao11Chun Zan12Yin Liu13Chest Hospital, Tianjin UniversityDepartment of Cardiology, Tianjin Chest HospitalTianjin Medical UniversityTianjin Medical UniversityDepartment of Cardiology, Tianjin Chest HospitalDepartment of Cardiology, Tianjin Chest HospitalDepartment of Cardiology, Tianjin Chest HospitalDepartment of Cardiology, Tianjin Chest HospitalDepartment of Cardiology, Tianjin Chest HospitalDepartment of Cardiology, Tianjin Chest HospitalDepartment of Cardiology, Tianjin Chest HospitalDepartment of Cardiology, Tianjin Chest HospitalDepartment of Cardiology, Tianjin Chest HospitalDepartment of Cardiology, Tianjin Chest HospitalAbstract Background COVID-19 affects healthcare resource allocation, which could lead to treatment delay and poor outcomes in patients with acute myocardial infarction (AMI). We assessed the impact of the COVID-19 pandemic on AMI outcomes. Methods We compared outcomes of patients admitted for acute ST-elevation MI (STEMI) and non-STEMI (NSTEMI) during a non-COVID-19 pandemic period (January–February 2019; Group 1, n = 254) and a COVID-19 pandemic period (January–February 2020; Group 2, n = 124). Results For STEMI patients, the median of first medical contact (FMC) time, door-to-balloon time, and total myocardial ischemia time were significantly longer in Group 2 patients (all p < 0.05). Primary percutaneous intervention was performed significantly more often in Group 1 patients than in Group 2 patients, whereas thrombolytic therapy was used significantly more often in Group 2 patients than in Group 1 patients (all p < 0.05). However, the rates of and all-cause 30-day mortality and major adverse cardiac event (MACE) were not significantly different in the two periods (all p > 0.05). For NSTEMI patients, Group 2 patients had a higher rate of conservative therapy, a lower rate of reperfusion therapy, and longer FMC times (all p < 0.05). All-cause 30-day mortality and MACE were only higher in NSTEMI patients during the COVID-19 pandemic period (p < 0.001). Conclusions COVID-19 pandemic causes treatment delay in AMI patients and potentially leads to poor clinical outcome in NSTEMI patients. Thrombolytic therapy should be initiated without delay for STEMI when coronary intervention is not readily available; for NSTEMI patients, outcomes of invasive reperfusion were better than medical treatment.https://doi.org/10.1186/s12872-022-02626-5Coronavirus disease-2019Acute myocardial infarctionFirst medical contact timeMajor adverse cardiac event |
| spellingShingle | Jing Gao Peng-Ju Lu Chang-Ping Li Hui Wang Ji-Xiang Wang Nan Zhang Xiao-Wei Li Hai-Wang Zhao Jing Dou Miao-Na Bai Yu-Tian Shi Jia Zhao Chun Zan Yin Liu Reconsidering treatment guidelines for acute myocardial infarction during the COVID-19 pandemic BMC Cardiovascular Disorders Coronavirus disease-2019 Acute myocardial infarction First medical contact time Major adverse cardiac event |
| title | Reconsidering treatment guidelines for acute myocardial infarction during the COVID-19 pandemic |
| title_full | Reconsidering treatment guidelines for acute myocardial infarction during the COVID-19 pandemic |
| title_fullStr | Reconsidering treatment guidelines for acute myocardial infarction during the COVID-19 pandemic |
| title_full_unstemmed | Reconsidering treatment guidelines for acute myocardial infarction during the COVID-19 pandemic |
| title_short | Reconsidering treatment guidelines for acute myocardial infarction during the COVID-19 pandemic |
| title_sort | reconsidering treatment guidelines for acute myocardial infarction during the covid 19 pandemic |
| topic | Coronavirus disease-2019 Acute myocardial infarction First medical contact time Major adverse cardiac event |
| url | https://doi.org/10.1186/s12872-022-02626-5 |
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