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Treatment delay and in-hospital outcomes in acute myocardial infarction during COVID-19 pandemic: experience in one of PCI centers in Lithuania
Tyrimo grupės vadovas / Research group head |
Date Issued |
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2021-05-14 |
Introduction: The COVID-19 outbreak has had a huge impact on the treatment and outcomes of patients (pts) with acute myocardial infarction (MI) (1). The pandemic of COVID-19 could cause an overload of the emergency medical systems, decreased awareness of pts fear of infection and that could lead to not receiving proper treatment (2). Aim: To assess the impact of the COVID-19 outbreak on incidence, delays and outcomes of pts with acute MI pts undergoing percutaneous coronary intervention (PCI). Methods: The study involved the pts with ST-segment elevation MI (STEMI) and non-ST-segment elevation MI (NSTEMI) - treated with PCI in Lithuanian Health Sciences University Hospital in 2019- 2020. The 2020 2nd quarter (qtr) matched the first COVID-19 pandemic lock-down, the 2020 4th qtr matched the second lock-down, the 2019 2nd and 4th qtr matched a pre-pandemic period. We compared demographic, logistical parameters and in hospital mortality rate. Statistical analysis was performed using SPSS 22.6 software. Continuous variables with normal distribution were presented as mean (±SD); non-normal variables - as median (minimum; maximum). P value <0.05 was considered significant data. Results: The overall sample consisted of 917 pts with NSTEMI (2019, n=530 vs 2020, n=387) and 1077 STEMI (2019, n=599 vs 2020, n=478). There were no statistically significant changes in age and gender within the 2019, 2020 years. Annual in-hospital mortality rate comparing 2019 and 2020 years in pts with STEMI increased (6.84% vs 10.06%, p=0.049), in NSTEMI was (4.77% vs 4.66%, p=0.310). Comparing 2019 2nd qtr and the first lock-down in 2020 mortality rate had a tendency to increase: 6,83% vs 9,01%, p=0.497 in STEMI pts; 3,47% vs 7,69%, p=0.156 in NSTEMI pts. Comparing 2019 4th and the second lock-down it was 6,5% vs 7,5%, p=0.779 in STEMI pts; 6,1% vs 2,5%,p=0.240 in NSTEMI pts. Comparing the 2019 2nd qtr and first lock-down in 2020 there wa[...].