- NEWS . 30 Nov 2020
Impact of the COVID-19 pandemic on inpatient management and outcomes of AMI
In light of the rapid spread of coronavirus disease 2019 (COVID-19) worldwide, researchers in China conducted a study to provide insights into the in-hospital management and outcomes of acute myocardial infarction (AMI) during the COVID-19 pandemic. They retrospectively analysed consecutive AMI patients, including those with ST-elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI), from 1 February 2020 to 15 April 2020 (during the COVID-19 pandemic), and from 1 January 2019 to 31 December 2019 (before the COVID-19 pandemic).
The findings revealed that STEMI patients during the COVID-19 pandemic had a longer delay time, less primary or remedial PCI, and more emergency thrombolysis compared with AMI patients before the pandemic. Rates of coronary angiography and stenting performed in AMI patients during the COVID-19 pandemic were lower than before the pandemic. Although there were no statistically significant differences in clinical outcomes between the matched patients, STEMI patients during the COVID-19 pandemic had a 4-fold increase in all-cause mortality rate compared with those before the pandemic (12.9% vs 3.2%). Lastly and not surprisingly, AMI combined with COVID-19 infection was linked to higher rates of mortality than AMI alone.
The study demonstrates that the COVID-19 pandemic has led to significant reperfusion delays in STEMI patients, and possibly impacting treatment option selection in AMI patients. Moreover, the mortality rate of STEMI patients showed an upward trend during the COVID-19 pandemic.
Huang B, et al. In-hospital management and outcomes of acute myocardial infarction before and during the coronavirus disease 2019 pandemic. J Cardiovasc Pharmacol 2020;76:540-548.