CCCardiol CroatCardiologia CroaticaCardiol. Croat.1848-543X1848-5448Croatian Cardiac SocietyCC 2021 16_1-2_710.15836/ccar2021.7Extended AbstractPercutaneous coronary intervention in acute myocardial infarction before and during the COVID-19 pandemic: first insights from a dedicated COVID-19 hospitalhttps://orcid.org/0000-0002-3768-9134HadžibegovićIrzal*https://orcid.org/0000-0002-4365-9652LisičićAntehttps://orcid.org/0000-0001-9912-2179UdovičićMariohttps://orcid.org/0000-0003-1567-8503RagužMiroslavhttps://orcid.org/0000-0002-4462-8647VuksanovićIlkohttps://orcid.org/0000-0002-1285-8042ČančarevićOgnjenhttps://orcid.org/0000-0003-0614-215XHulak-KarlakVanjahttps://orcid.org/0000-0002-2637-9691JurinIvanahttps://orcid.org/0000-0003-3404-3837BlivajsAleksandarhttps://orcid.org/0000-0001-6983-1409VitlovPetrahttps://orcid.org/0000-0002-3090-2772StarčevićBorisUniversity Hospital Dubrava, Zagreb, CroatiaADDRESS FOR CORRESPONDENCE: Irzal Hadžibegović, Klinička bolnica Dubrava, Avenija Gojka Šuška 6, HR-10000 Zagreb, Croatia. / Phone: +385-91-5333091 / E-mail: irzalh@gmail.com012021161-27706122020181220202021Croatian Cardiac SocietyKEYWORDS: myocardial infarctionpercutaneous coronary interventionCOVID-19
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.
LITERATURERupareliaNPanoulasV. The missing acute coronary syndromes in the COVID-19 era. . 2020 January-December;14:1753944720977732. 10.1177/175394472097773233274695