Percutaneous coronary intervention in acute myocardial infarction before and during the COVID-19 pandemic: first insights from a
dedicated COVID-19 hospital

    Authors

    Keywords

    myocardial infarction, percutaneous coronary intervention, COVID-19

    DOI

    https://doi.org/10.15836/ccar2021.7

    Full Text

    Background : COVID-19 pandemic has caused a worldwide situation of “missing patients” with acute myocardial infarction (AMI) suitable for a timely percutaneous coronary intervention (PCI). ( 1 ) We aimed to investigate the impact of COVID-19 pandemic on PCI in AMI (ST elevation + non ST elevation MIs) in a hospital included in the national primary PCI network and dedicated for COVID-19 patients from Mar 2020. Patients and Methods : We compared numbers, characteristics and outcomes of patients presenting with AMI and receiving timely percutaneous intervention in our hospital between two periods: Jan 2019 – Jan 2020 (“pre-COVID-19” era) and Mar 2020 – Dec 2020 (“COVID-19” era - 9 months period with mixed hospital organization: 4 months dedicated COVID-19 only hospital, and 5 months both non-COVID-19 and COVID-19 hospital). Results : In the pre-COVID-19 era we performed 434 PCIs in 505 patients with AMI who received urgent/early coronary angiography after admission (average monthly number of AMI suitable for revascularization: 42 patients), with in-hospital mortality of 3.7%. During the COVID-19 era there were 137 PCIs in 186 patients with AMI and urgent/early coronary angiography (average monthly number of AMI suitable for revascularization: 18 patients), with in-hospital mortality of 8%. During the COVID-19 era, there were 14 COVID-19 positive patients with acute AMI who underwent urgent angiography (8 received PCI and 6 were treated conservatively) and had in-hospital mortality of 28%. Conclusion : We found an astonishing 40% reduction in monthly rates of patients with AMI suitable for revascularization presenting to our hospital during the COVID-19 pandemic. AMI patients that were treated with PCI during the pandemic era had significantly higher mortality, mostly influenced by a very high mortality rate of COVID-19 positive patients presenting with AMI. Comprehensive analysis of national primary PCI network organization and patient awareness of AMI during COVID-19 pandemic in Croatia is warranted.

    Cardiologia Croatica
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    Percutaneous coronary intervention in acute myocardial infarction before and during the COVID-19 pandemic: first insights from a
dedicated COVID-19 hospital

    Extended Abstract
    Issue1-2
    Published
    Pages7
    PDF via DOIhttps://doi.org/10.15836/ccar2021.7
    myocardial infarction
    percutaneous coronary intervention
    COVID-19

    Authors

    Irzal Hadžibegović*ORCIDUniversity Hospital Dubrava, Zagreb, Croatia
    Ante LisičićORCIDUniversity Hospital Dubrava, Zagreb, Croatia
    Mario UdovičićORCIDUniversity Hospital Dubrava, Zagreb, Croatia
    Miroslav RagužORCIDUniversity Hospital Dubrava, Zagreb, Croatia
    Ilko VuksanovićORCIDUniversity Hospital Dubrava, Zagreb, Croatia
    Ognjen ČančarevićORCIDUniversity Hospital Dubrava, Zagreb, Croatia
    Vanja Hulak-KarlakORCIDUniversity Hospital Dubrava, Zagreb, Croatia
    Ivana JurinORCIDUniversity Hospital Dubrava, Zagreb, Croatia
    Aleksandar BlivajsORCIDUniversity Hospital Dubrava, Zagreb, Croatia
    Petra VitlovORCIDUniversity Hospital Dubrava, Zagreb, Croatia
    Boris StarčevićORCIDUniversity Hospital Dubrava, Zagreb, Croatia

    Full Text

    Background : COVID-19 pandemic has caused a worldwide situation of “missing patients” with acute myocardial infarction (AMI) suitable for a timely percutaneous coronary intervention (PCI). ( 1 ) We aimed to investigate the impact of COVID-19 pandemic on PCI in AMI (ST elevation + non ST elevation MIs) in a hospital included in the national primary PCI network and dedicated for COVID-19 patients from Mar 2020. Patients and Methods : We compared numbers, characteristics and outcomes of patients presenting with AMI and receiving timely percutaneous intervention in our hospital between two periods: Jan 2019 – Jan 2020 (“pre-COVID-19” era) and Mar 2020 – Dec 2020 (“COVID-19” era - 9 months period with mixed hospital organization: 4 months dedicated COVID-19 only hospital, and 5 months both non-COVID-19 and COVID-19 hospital). Results : In the pre-COVID-19 era we performed 434 PCIs in 505 patients with AMI who received urgent/early coronary angiography after admission (average monthly number of AMI suitable for revascularization: 42 patients), with in-hospital mortality of 3.7%. During the COVID-19 era there were 137 PCIs in 186 patients with AMI and urgent/early coronary angiography (average monthly number of AMI suitable for revascularization: 18 patients), with in-hospital mortality of 8%. During the COVID-19 era, there were 14 COVID-19 positive patients with acute AMI who underwent urgent angiography (8 received PCI and 6 were treated conservatively) and had in-hospital mortality of 28%. Conclusion : We found an astonishing 40% reduction in monthly rates of patients with AMI suitable for revascularization presenting to our hospital during the COVID-19 pandemic. AMI patients that were treated with PCI during the pandemic era had significantly higher mortality, mostly influenced by a very high mortality rate of COVID-19 positive patients presenting with AMI. Comprehensive analysis of national primary PCI network organization and patient awareness of AMI during COVID-19 pandemic in Croatia is warranted.