https://doi.org/10.4081/monaldi.2023.2502
Acute myocardial infarction during late COVID-19 era: patient characteristics, presentation and outcomes
Submitted: December 3, 2022
Accepted: December 15, 2022
Published: January 13, 2023
Accepted: December 15, 2022
Abstract Views: 1362
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All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Authors
COVID-19 pandemic has unquestionably influenced care of acute myocardial infarction (AMI). Still, its impact on patients (pts) characteristics, presentation, treatment, and outcomes remains not well established in late pandemic times. To address this issue, we performed a prospective study of type-1 AMI patients admitted in a tertiary care hospital. Pts were enrolled during 6-months in 2019 [n=122; pre-COVID-19 (PC) group] and in 2021 [n=196; late-COVID-19 (C) group]. Data was based on pts interview and review of medical records. Age and gender distribution, as well as ST/non-ST-elevation myocardial infarction (STEMI/NSTEMI) proportion and access to coronariography and revascularization were similar between groups. Group C patients presented more pre-existing established cardiovascular disease (CVD) (43% vs 30%; p=0.03); more frequent description of typical chest pain (94% vs 84%; p=0,002); higher levels of pain intensity, in a 0-10 scale (8±2 vs 7±2; p=0.02); higher frequencies of AMI complications (27% vs 15%; p=0.01) and worse Killip (K) class evolution (K≥2 in 22% C vs13% PC patients; p=0.05). In conclusion, late pandemic AMI patients presented worse in-hospital outcomes in our study, though pre-hospital and hospital care were comparable to pre-pandemic times. COVID patients had a higher burden of pre-existing established CVD and a more typical and intense symptom presentation. Therefore, it can be hypothesized that "sicker" patients continued to look for help when presenting AMI symptoms, while "less sick" patients and the ones with less typical and intense symptoms possibly avoided contact with health care services during late pandemic period.
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Ethics Approval
The study was approved by the Ethics Committee of “Centro Hospitalar Universitário de São João / Faculdade de Medicina da Universidade do Porto” on September 21, 2021 (reference number 290/21)How to Cite
Marques, Catarina Amaral, André Cabrita, Paulo Araújo, Tânia Proença, Ricardo Pinto, Miguel Carvalho, Catarina Costa, Ana Amador, João Calvão, and Cristina Cruz. 2023. “Acute Myocardial Infarction During Late COVID-19 Era: Patient Characteristics, Presentation and Outcomes”. Monaldi Archives for Chest Disease 93 (4). https://doi.org/10.4081/monaldi.2023.2502.
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