The influence of COVID-19 pandemic on management of acute myocardial infarction in Japan; Insight from the Miyagi AMI Registry Study.
The influence of COVID-19 pandemic on management of acute myocardial infarction in Japan; Insight from the Miyagi AMI Registry Study.
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DOI：
10.1016/j.ijcha.2022.101116
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发表时间：
2022-12
影响因子：
2.9
通讯作者：
Yasuda, Satoshi
中科院分区：
文献类型：
--
作者：
Hao, Kiyotaka;Takahashi, Jun;Sato, Koichi;Suda, Akira;Sindo, Tomohiko;Godo, Shigeo;Nishimiya, Kensuke;Kikuchi, Yoku;Shiroto, Takashi;Yasuda, Satoshi
由于冠状病毒病2019年(新冠肺炎)大流行，日本于2020年4月7日至5月25日宣布进入第一个紧急状态。这场大流行可能会影响急性心肌梗死(AMI)患者的治疗。方法和结果：为了评估新冠肺炎暴发期间急性心肌梗死患者的危重护理和预后，我们使用宫城急性心肌梗死注册研究数据库检查了2020年住院的急性心肌梗死患者(n=1186)和2017-2019年的急性心肌梗死患者(n=4877)。与2017-2019年同期相比，紧急状态声明下的门到设备时间变长[83(65-111)比74(54-108)分钟，p=0.04]。重要的是，只有抵达时Killip分级为I级的患者出现了时间延迟，而Killip分级为II~IV级的患者没有观察到时间延迟。同时，新冠肺炎爆发前后从症状出现到住院的时间、救护车的使用率和初次经皮冠状动脉介入治疗的实施率没有显著变化。最终，在紧急状态下，住院死亡率没有恶化(6.7vs7.8%，P=0.69)。结论：新冠肺炎疫情的出现似乎影响了急性心肌梗死的治疗，并强调了对心血管重症监护障碍的理解。
Due to the coronavirus disease 2019 (COVID-19) pandemic, the first state of emergency had been declared from April 7 to May 25, 2020, in Japan. This pandemic might affect the management for patients with acute myocardial infarction (AMI). Method and Results: To evaluate the critical care and outcomes of AMI patients during the COVID-19 outbreak, we examined the patients with AMI hospitalized in 2020 (n = 1186) and those in 2017–2019 (n = 4877) using a database of the Miyagi AMI Registry Study. The door-to-device time under the emergency declaration became longer as compared with that of the same period in 2017–2019 [83(65–111) vs 74(54–108) min, p = 0.04]. Importantly, the time delay was noted in only patients with Killip class I on arrival, but not in those with Killip class II–IV. Meanwhile, there were no significant changes in the duration from the symptom onset to hospital arrival, the use rate of ambulance and the performance rate of primary percutaneous coronary intervention before and after the COVID-19 outbreak. Eventually, in-hospital mortality had not deteriorated under the state of emergency (6.7 vs 7.8 %, P = 0.69). Conclusion: The emergence of the COVID-19 outbreak seemed to affect AMI management and highlight understanding the barriers to cardiovascular critical care.
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