Increase of Myocardial Ischemia Time and Short-Term Prognosis of Patients with Acute Myocardial Infarction during the First COVID-19 Pandemic Wave

• Published in: Medicina (Kaunas, Lithuania) Vol. 57; no. 12; p. 1296
• Main Authors: Budrys, Povilas, Lizaitis, Mindaugas, Cerlinskaite-Bajore, Kamile, Bajoras, Vilhelmas, Rodevic, Greta, Martinonyte, Aurelija, Dieckus, Laurynas, Badaras, Ignas, Serpytis, Pranas, Gurevicius, Romualdas, Visinskiene, Rasa, Buivydas, Romualdas, Volodko, Aleksandr, Urbonaite, Egle, Celutkiene, Jelena, Davidavicius, Giedrius
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 25.11.2021; MDPI
• Subjects: Communicable Disease Control; Coronaviruses; COVID-19; Humans; ischemia time; Medical imaging; Mortality; myocardial infarction; Myocardial Infarction - epidemiology; Pandemics; Percutaneous Coronary Intervention; Prognosis; Retrospective Studies; SARS-CoV-2; ST Elevation Myocardial Infarction; Treatment Outcome; Lithuania; COVID-19; ischemia time; percutaneous coronary intervention; myocardial infarction
• ISSN: 1648-9144; 1010-660X; 1648-9144
• DOI: 10.3390/medicina57121296

: early reports showed a decrease in admission rates and an increase in mortality of patients with acute myocardial infarction (AMI) during the first wave of COVID-19 pandemic. We sought to investigate whether the COVID-19 pandemic and associated lockdown had an impact on the ischemia time and prognosis of patients suffering from AMI in the settings of low COVID-19 burden. we conducted a retrospective data analysis from a tertiary center in Lithuania of 818 patients with AMI. Data were collected from 1 March to 30 June in 2020 during the peri-lockdown period (2020 group; = 278) and compared to the same period last year (2019 group; = 326). The primary study endpoint was all-cause mortality during 3 months of follow-up. Secondary endpoints were heart failure severity (Killip class) on admission and ischemia time in patients with acute ST segment elevation myocardial infarction (STEMI). there was a reduction of 14.7% in admission rate for acute myocardial infarction (AMI) during the peri-lockdown period. The 3-month mortality rate did not differ significantly (6.9% in 2020 vs. 10.5% in 2019, = 0.341 for STEMI patients; 5.3% in 2020 vs. 2.6% in 2019, = 0.374 for patients with acute myocardial infarction without ST segment elevation (NSTEMI)). More STEMI patients presented with Killip IV class in 2019 (13.5% vs. 5.5%, = 0.043, respectively). There was an increase of door-to-PCI time (54.0 [42.0-86.0] in 2019; 63.5 [48.3-97.5] in 2020, = 0.018) and first medical contact (FMC)-to-PCI time (101.0 [82.5-120.8] in 2019; 115 [97.0-154.5] in 2020, = 0.01) during the pandemic period. There was a 14.7% reduction of admissions for AMI during the first wave of COVID-19. FMC-to-PCI time increased during the peri-lockdown period, however, it did not translate into worse survival during follow-up.