Six-Month Outcomes for COVID-19 Negative Patients with Acute Myocardial Infarction Before Versus During the COVID-19 Pandemic.
Six-Month Outcomes for COVID-19 Negative Patients with Acute Myocardial Infarction Before Versus During the COVID-19 Pandemic.
复制标题
DOI：
10.1016/j.amjcard.2021.01.043
复制
发表时间：
2021-05-15
期刊：
影响因子：
--
通讯作者：
McCullough PA
中科院分区：
文献类型：
--
作者：
Aldujeli A;Hamadeh A;Tecson KM;Krivickas Z;Maciulevicius L;Stiklioraitis S;Sukys M;Briedis K;Aldujeili M;Briede K;Braukyliene R;Pranculis A;Unikas R;Zaliaduonyte D;McCullough PA
2019冠状病毒病（COVID-19）大流行改变了患者寻求医疗服务的方式和提供医疗服务的方式。我们试图比较大流行期间与大流行前急性心肌梗死（AMI）患者的特征、临床病程和结局。这是一项多中心回顾性队列研究，将立陶宛2020年3月11日至2020年4月20日连续的COVID-19阴性AMI患者与2019年同期入院的相同诊断的患者进行比较。所有患者均行血管造影。所有患者随访6个月。该研究共纳入269例患者，其中107例（40.8%）在大流行期间出现。在大流行期间就诊的患者，从疼痛到开门的中位数时间明显更长（858[四分位数1=360，四分位数3 = 2600]vs 385.5[200,745]分钟，p <0.0001），血运重建后的射血分数显著较低（35 [30,45]vs 45 [40,50], p <0.0001）。虽然住院死亡率没有差异，但我们观察到在大流行期间出现的患者6个月主要不良心血管事件发生率高于大流行前（30.8% vs 13.6%, p = 0.0006）。总之，与大流行前入院的患者相比，在COVID-19大流行期间入院的AMI患者减少了34%，并且等待更长时间才入院的患者经历了更多6个月的主要不良心血管事件。
The Coronavirus disease 2019 (COVID-19) pandemic has changed the way patients seek medical attention and how medical services are provided. We sought to compare characteristics, clinical course, and outcomes of patients presenting with acute myocardial infarction (AMI) during the pandemic compared with before it. This is a multicenter, retrospective cohort study of consecutive COVID-19 negative patients with AMI in Lithuania from March 11, 2020 to April 20, 2020 compared with patients admitted with the same diagnosis during the same period in 2019. All patients underwent angiography. Six-month follow-up was obtained for all patients. A total of 269 patients were included in this study, 107 (40.8%) of whom presented during the pandemic. Median pain-to-door times were significantly longer (858 [quartile 1=360, quartile 3 = 2,600] vs 385.5 [200, 745] minutes, p <0.0001) and post-revascularization ejection fractions were significantly lower (35 [30, 45] vs 45 [40, 50], p <0.0001) for patients presenting during vs. prior to the pandemic. While the in-hospital mortality rate did not differ, we observed a higher rate of six-month major adverse cardiovascular events for patients who presented during versus prior to the pandemic (30.8% vs 13.6%, p = 0.0006). In conclusion, 34% fewer patients with AMI presented to the hospital during the COVID-19 pandemic, and those who did waited longer to present and experienced more 6-month major adverse cardiovascular events compared with patients admitted before the pandemic.