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COVID-19 pandemic is associated with mechanical complications in patients with ST-elevation myocardial infarction

OBJECTIVE: Although there are regional reports that the COVID-19 pandemic is associated with a reduction in acute myocardial infarction presentations and primary percutaneous coronary intervention (PCI) procedures, little is known about the impact of the COVID-19 pandemic on mechanical complications...

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Autores principales: Kitahara, Satoshi, Fujino, Masashi, Honda, Satoshi, Asaumi, Yasuhide, Kataoka, Yu, Otsuka, Fumiyuki, Nakanishi, Michio, Tahara, Yoshio, Ogata, Soshiro, Onozuka, Daisuke, Nishimura, Kunihiro, Fujita, Tomoyuki, Tsujita, Kenichi, Ogawa, Hisao, Noguchi, Teruo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7871043/
https://www.ncbi.nlm.nih.gov/pubmed/33547221
http://dx.doi.org/10.1136/openhrt-2020-001497
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author Kitahara, Satoshi
Fujino, Masashi
Honda, Satoshi
Asaumi, Yasuhide
Kataoka, Yu
Otsuka, Fumiyuki
Nakanishi, Michio
Tahara, Yoshio
Ogata, Soshiro
Onozuka, Daisuke
Nishimura, Kunihiro
Fujita, Tomoyuki
Tsujita, Kenichi
Ogawa, Hisao
Noguchi, Teruo
author_facet Kitahara, Satoshi
Fujino, Masashi
Honda, Satoshi
Asaumi, Yasuhide
Kataoka, Yu
Otsuka, Fumiyuki
Nakanishi, Michio
Tahara, Yoshio
Ogata, Soshiro
Onozuka, Daisuke
Nishimura, Kunihiro
Fujita, Tomoyuki
Tsujita, Kenichi
Ogawa, Hisao
Noguchi, Teruo
author_sort Kitahara, Satoshi
collection PubMed
description OBJECTIVE: Although there are regional reports that the COVID-19 pandemic is associated with a reduction in acute myocardial infarction presentations and primary percutaneous coronary intervention (PCI) procedures, little is known about the impact of the COVID-19 pandemic on mechanical complications resulting from ST-segment elevation myocardial infarction (STEMI) and mortality. METHODS: This single-centre retrospective cohort study analysed presentations, incidence of mechanical complications, and mortality in patients with STEMI before and after a state of emergency was declared due to the COVID-19 pandemic by the Japanese government on 7 April 2020. RESULTS: We analysed 359 patients with STEMI hospitalised before the declaration and 63 patients hospitalised after the declaration. The proportion of patients with late presentation was significantly higher after the declaration than before (25.4% vs 14.2%, p=0.03). The incidence of late presentation was significantly higher during the COVID-19 pandemic than before (incidence rate ratio (IRR), 2.41; 95% CI, 1.37 to 4.05; p=0.001, even after adjusting for month (IRR, 2.61; 95% CI, 1.33 to 5.13; p<0.01). Primary PCI was performed significantly less often after the declaration than before (68.3% vs 82.5%, p=0.009). The mechanical complication resulting from STEMI occurred in 13 of 359 (3.6%) patients before the declaration and 9 of 63 (14.3%) patients after the declaration (p<0.001). However, the incidence of in-hospital death (before, 6.2% vs after, 6.4%, p=0.95) was comparable. CONCLUSIONS: Following the COVID-19 pandemic, an increased incidence of mechanical complications resulting from STEMI was observed. Instructing people to stay at home, without effectively educating them to immediately seek medical attention when suffering symptoms of a heart attack, may worsen outcomes in patients with STEMI.
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spelling pubmed-78710432021-02-09 COVID-19 pandemic is associated with mechanical complications in patients with ST-elevation myocardial infarction Kitahara, Satoshi Fujino, Masashi Honda, Satoshi Asaumi, Yasuhide Kataoka, Yu Otsuka, Fumiyuki Nakanishi, Michio Tahara, Yoshio Ogata, Soshiro Onozuka, Daisuke Nishimura, Kunihiro Fujita, Tomoyuki Tsujita, Kenichi Ogawa, Hisao Noguchi, Teruo Open Heart Coronary Artery Disease OBJECTIVE: Although there are regional reports that the COVID-19 pandemic is associated with a reduction in acute myocardial infarction presentations and primary percutaneous coronary intervention (PCI) procedures, little is known about the impact of the COVID-19 pandemic on mechanical complications resulting from ST-segment elevation myocardial infarction (STEMI) and mortality. METHODS: This single-centre retrospective cohort study analysed presentations, incidence of mechanical complications, and mortality in patients with STEMI before and after a state of emergency was declared due to the COVID-19 pandemic by the Japanese government on 7 April 2020. RESULTS: We analysed 359 patients with STEMI hospitalised before the declaration and 63 patients hospitalised after the declaration. The proportion of patients with late presentation was significantly higher after the declaration than before (25.4% vs 14.2%, p=0.03). The incidence of late presentation was significantly higher during the COVID-19 pandemic than before (incidence rate ratio (IRR), 2.41; 95% CI, 1.37 to 4.05; p=0.001, even after adjusting for month (IRR, 2.61; 95% CI, 1.33 to 5.13; p<0.01). Primary PCI was performed significantly less often after the declaration than before (68.3% vs 82.5%, p=0.009). The mechanical complication resulting from STEMI occurred in 13 of 359 (3.6%) patients before the declaration and 9 of 63 (14.3%) patients after the declaration (p<0.001). However, the incidence of in-hospital death (before, 6.2% vs after, 6.4%, p=0.95) was comparable. CONCLUSIONS: Following the COVID-19 pandemic, an increased incidence of mechanical complications resulting from STEMI was observed. Instructing people to stay at home, without effectively educating them to immediately seek medical attention when suffering symptoms of a heart attack, may worsen outcomes in patients with STEMI. BMJ Publishing Group 2021-02-05 /pmc/articles/PMC7871043/ /pubmed/33547221 http://dx.doi.org/10.1136/openhrt-2020-001497 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Coronary Artery Disease
Kitahara, Satoshi
Fujino, Masashi
Honda, Satoshi
Asaumi, Yasuhide
Kataoka, Yu
Otsuka, Fumiyuki
Nakanishi, Michio
Tahara, Yoshio
Ogata, Soshiro
Onozuka, Daisuke
Nishimura, Kunihiro
Fujita, Tomoyuki
Tsujita, Kenichi
Ogawa, Hisao
Noguchi, Teruo
COVID-19 pandemic is associated with mechanical complications in patients with ST-elevation myocardial infarction
title COVID-19 pandemic is associated with mechanical complications in patients with ST-elevation myocardial infarction
title_full COVID-19 pandemic is associated with mechanical complications in patients with ST-elevation myocardial infarction
title_fullStr COVID-19 pandemic is associated with mechanical complications in patients with ST-elevation myocardial infarction
title_full_unstemmed COVID-19 pandemic is associated with mechanical complications in patients with ST-elevation myocardial infarction
title_short COVID-19 pandemic is associated with mechanical complications in patients with ST-elevation myocardial infarction
title_sort covid-19 pandemic is associated with mechanical complications in patients with st-elevation myocardial infarction
topic Coronary Artery Disease
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7871043/
https://www.ncbi.nlm.nih.gov/pubmed/33547221
http://dx.doi.org/10.1136/openhrt-2020-001497
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