COVID-19 pandemic is associated with mechanical complications in patients with ST-elevation myocardial infarction.
Aged
Aged, 80 and over
COVID-19
Female
Hospital Mortality
Hospitalization
Humans
Japan
Male
Middle Aged
Patient Acceptance of Health Care
Percutaneous Coronary Intervention
/ adverse effects
Registries
Retrospective Studies
Risk Assessment
Risk Factors
ST Elevation Myocardial Infarction
/ diagnosis
Time Factors
Time-to-Treatment
Treatment Outcome
acute coronary syndrome
epidemiology
myocardial infarction
Journal
Open heart
ISSN: 2053-3624
Titre abrégé: Open Heart
Pays: England
ID NLM: 101631219
Informations de publication
Date de publication:
02 2021
02 2021
Historique:
received:
28
10
2020
revised:
31
12
2020
accepted:
18
01
2021
entrez:
6
2
2021
pubmed:
7
2
2021
medline:
20
2
2021
Statut:
ppublish
Résumé
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.
Identifiants
pubmed: 33547221
pii: openhrt-2020-001497
doi: 10.1136/openhrt-2020-001497
pmc: PMC7871043
pii:
doi:
Types de publication
Comparative Study
Journal Article
Observational Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
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