Impact of the COVID-19 pandemic on hospitalizations for acute coronary syndromes: A multinational study

D. Araiza-Garaygordobil, C. Montalto, P. Martinez-Amezcua, A. Cabello-Lopez, R. Gopar-Nieto, R. Alabrese, A. Almaghraby, S. Catoya-Villa, M. Chacon-Diaz, C. C. Kaufmann, M. Corbi-Pascual, P. Deharo, M. El-Tahlawi, A. Elgohari-Abdelwahab, F. Guerra, M. Jarakovic, E. Martinez-Gomez, L. Moderato, S. Montero, P. Morejon-BarraganA. M. Omar, P. Jorge-Pérez, P. Przybyło, E. Selim, U. Y. Sinan, M. Stratinaki, O. Tica, M. Trêpa, A. Uribarri, J. Uzokov, K. Wilk, K. Czerwińska-Jelonkiewicz, A. Sionis, M. Gierlotka, S. Leonardi, K. A. Krychtiuk, G. Tavazzi

Research output: Contribution to journalArticlepeer-review

13 Scopus citations

Abstract

Background: COVID-19 has challenged the health system organization requiring a fast reorganization of diagnostic/therapeutic pathways for patients affected by time-dependent diseases such as acute coronary syndromes (ACS). Aim: To describe ACS hospitalizations, management, and complication rate before and after the COVID-19 pandemic was declared. Design: Ecological retrospective study. Methods: We analyzed aggregated epidemiological data of all patients > 18 years old admitted for ACS in twenty-nine hub cardiac centers from 17 Countries across 4 continents, from December 1st, 2019 to April 15th, 2020. Data from December 2018 to April 2019 were used as historical period. Results: A significant overall trend for reduction in the weekly number of ACS hospitalizations was observed (20.2%; 95% confidence interval CI [1.6, 35.4] P = 0.04). The incidence rate reached a 54% reduction during the second week of April (incidence rate ratio: 0.46, 95% CI [0.36, 0.58]) and was also significant when compared to the same months in 2019 (March and April, respectively IRR: 0.56, 95%CI [0.48, 0.67]; IRR: 0.43, 95%CI [0.32, 0.58] p < 0.001). A significant increase in door-to-balloon, door-to-needle, and total ischemic time (p <0.04 for all) in STEMI patents were reported during pandemic period. Finally, the proportion of patients with mechanical complications was higher (1.98% vs. 0.98%; P = 0.006) whereas GRACE risk score was not different. Conclusions: Our results confirm that COVID-19 pandemic was associated with a significant decrease in ACS hospitalizations rate, an increase in total ischemic time and a higher rate of mechanical complications on a international scale.

Original languageEnglish
Pages (from-to)642-647
Number of pages6
JournalQJM
Volume114
Issue number9
DOIs
StatePublished - 1 Sep 2021
Externally publishedYes

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