COVID-19 pandemic is associated with mechanical complications in patients with ST-elevation myocardial infarction.
COVID-19 pandemic is associated with mechanical complications in patients with ST-elevation myocardial infarction.
复制标题
COVID-19大流行与ST段抬高型心肌梗死患者的机械并发症相关。
DOI：
10.1136/openhrt-2020-001497
复制
发表时间：
2021-03
期刊：
影响因子：
2.7
通讯作者：
Noguchi T
中科院分区：
文献类型：
--
作者：
Kitahara S;Fujino M;Honda S;Asaumi Y;Kataoka Y;Otsuka F;Nakanishi M;Tahara Y;Ogata S;Onozuka D;Nishimura K;Fujita T;Tsujita K;Ogawa H;Noguchi T
尽管有地区报告称，COVID-19大流行与急性心肌梗死表现和直接经皮冠状动脉介入治疗（PCI）手术的减少有关，但人们对COVID-19大流行对ST段抬高型心肌梗死（STEMI）导致的机械并发症和死亡率的影响知之甚少。这项单中心回顾性队列研究分析了日本政府于2020年4月7日因COVID-19大流行宣布紧急状态前后STEMI患者的表现、机械并发症发生率和死亡率。我们分析了359例STEMI患者在声明前住院，63例患者在声明后住院。声明后迟发性疾病的患者比例显著高于声明前（25.4% vs 14.2%，p=0.03）。在COVID-19大流行期间，迟发性疾病的发生率显著高于之前（发病率比（IRR），2.41; 95%CI，1.37至4.05; p=0.001，即使在调整月份后（IRR，2.61; 95%CI，1.33至5.13; p<0.01）。宣布后进行直接PCI的频率明显低于宣布前（68.3% vs 82.5%，p=0.009）。STEMI导致的机械并发症在声明前359例患者中有13例（3.6%）发生，在声明后63例患者中有9例（14.3%）发生（p<0.001）。然而，院内死亡的发生率（治疗前6.2% vs治疗后6.4%，p=0.95）相当。COVID-19大流行后，观察到STEMI导致的机械并发症发生率增加。指导人们呆在家里，而没有有效地教育他们在出现心脏病发作症状时立即就医，可能会使STEMI患者的预后恶化。
Although there are regional reports that the COVID-19 pandemic is associated with a reduction in acute myocardial infarction presentations and primary percutaneous coronary intervention (PCI) procedures, little is known about the impact of the COVID-19 pandemic on mechanical complications resulting from ST-segment elevation myocardial infarction (STEMI) and mortality. This single-centre retrospective cohort study analysed presentations, incidence of mechanical complications, and mortality in patients with STEMI before and after a state of emergency was declared due to the COVID-19 pandemic by the Japanese government on 7 April 2020. We analysed 359 patients with STEMI hospitalised before the declaration and 63 patients hospitalised after the declaration. The proportion of patients with late presentation was significantly higher after the declaration than before (25.4% vs 14.2%, p=0.03). The incidence of late presentation was significantly higher during the COVID-19 pandemic than before (incidence rate ratio (IRR), 2.41; 95% CI, 1.37 to 4.05; p=0.001, even after adjusting for month (IRR, 2.61; 95% CI, 1.33 to 5.13; p<0.01). Primary PCI was performed significantly less often after the declaration than before (68.3% vs 82.5%, p=0.009). The mechanical complication resulting from STEMI occurred in 13 of 359 (3.6%) patients before the declaration and 9 of 63 (14.3%) patients after the declaration (p<0.001). However, the incidence of in-hospital death (before, 6.2% vs after, 6.4%, p=0.95) was comparable. Following the COVID-19 pandemic, an increased incidence of mechanical complications resulting from STEMI was observed. Instructing people to stay at home, without effectively educating them to immediately seek medical attention when suffering symptoms of a heart attack, may worsen outcomes in patients with STEMI.
登录
查看更多内容
影响因子：
5.4
作者：
Honda S;Asaumi Y;Yamane T;Nagai T;Miyagi T;Noguchi T;Anzai T;Goto Y;Ishihara M;Nishimura K;Ogawa H;Ishibashi-Ueda H;Yasuda S
通讯作者：
Yasuda S
DOI：
10.1097/ede.0b013e3181a819a1
发表时间：
2009-07
期刊：
Epidemiology (Cambridge, Mass.)
影响因子：
--
作者：
Schisterman EF;Cole SR;Platt RW
通讯作者：
Platt RW
影响因子：
2.8
作者：
Fujino, Masashi;Ishihara, Masaharu;Ogawa, Hisao
通讯作者：
Ogawa, Hisao
影响因子：
37.8
作者：
Figueras, Jaume;Alcalde, Oscar;Lidon, Rosa-Maria
通讯作者：
Lidon, Rosa-Maria
影响因子：
5.2
作者：
Jacobson, Nicholas C.;Lekkas, Damien;Barr, Paul J.
通讯作者：
Barr, Paul J.