Worrisome trends of ST-elevation myocardial infarction during the Covid-19 pandemic: Data from Portuguese centers

Luís Oliveira; Rui Campante Teles; Carina Machado; Sérgio Madeira; Nélson Vale; Carla Almeida; João Brito; Sílvio Leal; Luís Raposo; Pedro de Araújo Gonçalves; António Miguel Pacheco; Henrique Mesquita Gabriel; Manuel Almeida; Dinis Martins; Miguel Mendes

doi:10.1016/j.repc.2021.03.012

Worrisome trends of ST-elevation myocardial infarction during the Covid-19 pandemic: Data from Portuguese centers

Luís Oliveira, Rui Campante Teles, Carina Machado, Sérgio Madeira, Nélson Vale, Carla Almeida, João Brito, Sílvio Leal, Luís Raposo, Pedro de Araújo Gonçalves, António Miguel Pacheco, Henrique Mesquita Gabriel, Manuel Almeida, Dinis Martins, Miguel Mendes

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Abstract

INTRODUCTION: During the Covid-19 pandemic there has been a general belief that hospital admissions for non-infectious causes, especially cardiovascular disease, have fallen.

OBJECTIVES: To assess the impact of the pandemic on admissions for ST-elevation myocardial infarction (STEMI) during the first pandemic wave.

METHODS: We performed a multicenter retrospective analysis of consecutive patients presenting with STEMI in two Portuguese hospital centers in two sequential periods - P1 (March 1 to April 30) and P2 (May 1 to June 30). Patients' clinical data and hospital outcomes were compared between the two periods for the years 2017 to 2019 and for 2020.

RESULTS: During P1 in 2020, a reduction in the number of STEMI patients was observed in comparison with previous years (26.0±4.2 vs. 16.5±4.9 cases per month; p=0.033), as well as an increase in the number of mechanical complications (0.0% vs. 3.0%; p=0.029). Percutaneous coronary interventions in the setting of failed thrombolysis were more frequent (1.9% vs. 9.1%; p=0.033). An overall trend for longer delays in key timings of STEMI care bundles was noted. Mortality was higher during P1 compared to previous years (1.9% vs. 12.1%; p=0.005).

CONCLUSIONS: During the first Covid-19 wave fewer patients presented with STEMI at the catheterization laboratory for percutaneous coronary intervention. These patients presented more mechanical complications and higher mortality.

Original language	Portuguese
Pages (from-to)	465-471
Journal	Revista Portuguesa de Cardiologia
Volume	41
Issue number	6
Early online date	17 Feb 2022
DOIs	https://doi.org/10.1016/j.repc.2021.03.012
Publication status	Published - Jun 2022

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10.1016/j.repc.2021.03.012

1-s2.0-S0870255122000622-mainFinal published version, 477 KBLicence: CC BY-NC-ND

Cite this

Oliveira, L., Teles, R. C., Machado, C., Madeira, S., Vale, N., Almeida, C., Brito, J., Leal, S., Raposo, L., de Araújo Gonçalves, P., Pacheco, A. M., Gabriel, H. M., Almeida, M., Martins, D., & Mendes, M. (2022). Worrisome trends of ST-elevation myocardial infarction during the Covid-19 pandemic: Data from Portuguese centers. Revista Portuguesa de Cardiologia, 41(6), 465-471. Advance online publication. https://doi.org/10.1016/j.repc.2021.03.012

@article{22ee24168d9a4fc3b1b31c4758adc796,

title = "Worrisome trends of ST-elevation myocardial infarction during the Covid-19 pandemic: Data from Portuguese centers",

abstract = "INTRODUCTION: During the Covid-19 pandemic there has been a general belief that hospital admissions for non-infectious causes, especially cardiovascular disease, have fallen.OBJECTIVES: To assess the impact of the pandemic on admissions for ST-elevation myocardial infarction (STEMI) during the first pandemic wave.METHODS: We performed a multicenter retrospective analysis of consecutive patients presenting with STEMI in two Portuguese hospital centers in two sequential periods - P1 (March 1 to April 30) and P2 (May 1 to June 30). Patients' clinical data and hospital outcomes were compared between the two periods for the years 2017 to 2019 and for 2020.RESULTS: During P1 in 2020, a reduction in the number of STEMI patients was observed in comparison with previous years (26.0±4.2 vs. 16.5±4.9 cases per month; p=0.033), as well as an increase in the number of mechanical complications (0.0% vs. 3.0%; p=0.029). Percutaneous coronary interventions in the setting of failed thrombolysis were more frequent (1.9% vs. 9.1%; p=0.033). An overall trend for longer delays in key timings of STEMI care bundles was noted. Mortality was higher during P1 compared to previous years (1.9% vs. 12.1%; p=0.005).CONCLUSIONS: During the first Covid-19 wave fewer patients presented with STEMI at the catheterization laboratory for percutaneous coronary intervention. These patients presented more mechanical complications and higher mortality.",

author = "Lu{\'i}s Oliveira and Teles, {Rui Campante} and Carina Machado and S{\'e}rgio Madeira and N{\'e}lson Vale and Carla Almeida and Jo{\~a}o Brito and S{\'i}lvio Leal and Lu{\'i}s Raposo and {de Ara{\'u}jo Gon{\c c}alves}, Pedro and Pacheco, {Ant{\'o}nio Miguel} and Gabriel, {Henrique Mesquita} and Manuel Almeida and Dinis Martins and Miguel Mendes",

note = "{\textcopyright} 2022 Sociedade Portuguesa de Cardiologia. Published by Elsevier Espa{\~n}a, S.L.U.",

year = "2022",

month = jun,

doi = "10.1016/j.repc.2021.03.012",

language = "Portuguese",

volume = "41",

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journal = "Revista Portuguesa de Cardiologia",

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Oliveira, L, Teles, RC, Machado, C, Madeira, S, Vale, N, Almeida, C, Brito, J, Leal, S, Raposo, L , de Araújo Gonçalves, P, Pacheco, AM, Gabriel, HM, Almeida, M, Martins, D & Mendes, M 2022, 'Worrisome trends of ST-elevation myocardial infarction during the Covid-19 pandemic: Data from Portuguese centers', Revista Portuguesa de Cardiologia, vol. 41, no. 6, pp. 465-471. https://doi.org/10.1016/j.repc.2021.03.012

TY - JOUR

T1 - Worrisome trends of ST-elevation myocardial infarction during the Covid-19 pandemic

T2 - Data from Portuguese centers

AU - Oliveira, Luís

AU - Teles, Rui Campante

AU - Machado, Carina

AU - Madeira, Sérgio

AU - Vale, Nélson

AU - Almeida, Carla

AU - Brito, João

AU - Leal, Sílvio

AU - Raposo, Luís

AU - de Araújo Gonçalves, Pedro

AU - Pacheco, António Miguel

AU - Gabriel, Henrique Mesquita

AU - Almeida, Manuel

AU - Martins, Dinis

AU - Mendes, Miguel

PY - 2022/6

Y1 - 2022/6

N2 - INTRODUCTION: During the Covid-19 pandemic there has been a general belief that hospital admissions for non-infectious causes, especially cardiovascular disease, have fallen.OBJECTIVES: To assess the impact of the pandemic on admissions for ST-elevation myocardial infarction (STEMI) during the first pandemic wave.METHODS: We performed a multicenter retrospective analysis of consecutive patients presenting with STEMI in two Portuguese hospital centers in two sequential periods - P1 (March 1 to April 30) and P2 (May 1 to June 30). Patients' clinical data and hospital outcomes were compared between the two periods for the years 2017 to 2019 and for 2020.RESULTS: During P1 in 2020, a reduction in the number of STEMI patients was observed in comparison with previous years (26.0±4.2 vs. 16.5±4.9 cases per month; p=0.033), as well as an increase in the number of mechanical complications (0.0% vs. 3.0%; p=0.029). Percutaneous coronary interventions in the setting of failed thrombolysis were more frequent (1.9% vs. 9.1%; p=0.033). An overall trend for longer delays in key timings of STEMI care bundles was noted. Mortality was higher during P1 compared to previous years (1.9% vs. 12.1%; p=0.005).CONCLUSIONS: During the first Covid-19 wave fewer patients presented with STEMI at the catheterization laboratory for percutaneous coronary intervention. These patients presented more mechanical complications and higher mortality.

AB - INTRODUCTION: During the Covid-19 pandemic there has been a general belief that hospital admissions for non-infectious causes, especially cardiovascular disease, have fallen.OBJECTIVES: To assess the impact of the pandemic on admissions for ST-elevation myocardial infarction (STEMI) during the first pandemic wave.METHODS: We performed a multicenter retrospective analysis of consecutive patients presenting with STEMI in two Portuguese hospital centers in two sequential periods - P1 (March 1 to April 30) and P2 (May 1 to June 30). Patients' clinical data and hospital outcomes were compared between the two periods for the years 2017 to 2019 and for 2020.RESULTS: During P1 in 2020, a reduction in the number of STEMI patients was observed in comparison with previous years (26.0±4.2 vs. 16.5±4.9 cases per month; p=0.033), as well as an increase in the number of mechanical complications (0.0% vs. 3.0%; p=0.029). Percutaneous coronary interventions in the setting of failed thrombolysis were more frequent (1.9% vs. 9.1%; p=0.033). An overall trend for longer delays in key timings of STEMI care bundles was noted. Mortality was higher during P1 compared to previous years (1.9% vs. 12.1%; p=0.005).CONCLUSIONS: During the first Covid-19 wave fewer patients presented with STEMI at the catheterization laboratory for percutaneous coronary intervention. These patients presented more mechanical complications and higher mortality.

U2 - 10.1016/j.repc.2021.03.012

DO - 10.1016/j.repc.2021.03.012

M3 - Article

C2 - 35194311

SN - 0870-2551

VL - 41

SP - 465

EP - 471

JO - Revista Portuguesa de Cardiologia

JF - Revista Portuguesa de Cardiologia

IS - 6

ER -