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Outcomes and mechanical complications of acute myocardial infarction during the second wave pandemic in a Milan HUB center for cardiac emergencies

AIMS: COVID-19 has dramatically impacted the healthcare system. Evidence from previous studies suggests a decline in in-hospital admissions for acute myocardial infarction (AMI) during the pandemic. However, the effect of the pandemic on mechanical complications (MC) in acute ST-segment elevation my...

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Autores principales: Penso, Marco, Frappampina, Antonio, Cosentino, Nicola, Tamborini, Gloria, Celeste, Fabrizio, Ianniruberto, Monica, Ravagnani, Paolo, Troiano, Sarah, Marenzi, Giancarlo, Pepi, Mauro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9573996/
https://www.ncbi.nlm.nih.gov/pubmed/36262205
http://dx.doi.org/10.3389/fcvm.2022.950952
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author Penso, Marco
Frappampina, Antonio
Cosentino, Nicola
Tamborini, Gloria
Celeste, Fabrizio
Ianniruberto, Monica
Ravagnani, Paolo
Troiano, Sarah
Marenzi, Giancarlo
Pepi, Mauro
author_facet Penso, Marco
Frappampina, Antonio
Cosentino, Nicola
Tamborini, Gloria
Celeste, Fabrizio
Ianniruberto, Monica
Ravagnani, Paolo
Troiano, Sarah
Marenzi, Giancarlo
Pepi, Mauro
author_sort Penso, Marco
collection PubMed
description AIMS: COVID-19 has dramatically impacted the healthcare system. Evidence from previous studies suggests a decline in in-hospital admissions for acute myocardial infarction (AMI) during the pandemic. However, the effect of the pandemic on mechanical complications (MC) in acute ST-segment elevation myocardial infarction (STEMI) has not been comprehensively investigated. Therefore, we evaluated the impact of the pandemic on MC and in-hospital outcomes in STEMI during the second wave, in which there was a huge SARS-CoV-2 diffusion in Italy. METHODS AND RESULTS: Based on a single center cohort of AMI patients admitted with STEMI between February 1, 2019, and February 28, 2021, we compared the characteristics and outcomes of STEMI patients treated during the pandemic vs. those treated before the pandemic. In total, 479 STEMI patients were included, of which 64.5% were during the pandemic. Relative to before the pandemic, primary percutaneous coronary intervention (PCI) declined (87.7 vs. 94.7%, p = 0.014) during the pandemic. Compared to those admitted before the pandemic (10/2019 to 2/2020), STEMI patients admitted during the second wave (10/2020 to 2/2021) presented with a symptom onset-to-door time greater than 24 h (26.1 vs. 10.3%, p = 0.009) and a reduction of primary PCI (85.2 vs. 97.1%, p = 0.009). MC occurred more often in patients admitted during the second wave of the pandemic than in those admitted before the pandemic (7.0 vs. 0.0%, p = 0.032). In-hospital mortality increased during the second wave (10.6 vs. 2.9%, p = 0.058). CONCLUSION: Although the experience gained during the first wave and a more advanced hub-and-spoke system for cardiovascular emergencies persists, late hospitalizations and a high incidence of mechanical complications in STEMI were observed even in the second wave.
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spelling pubmed-95739962022-10-18 Outcomes and mechanical complications of acute myocardial infarction during the second wave pandemic in a Milan HUB center for cardiac emergencies Penso, Marco Frappampina, Antonio Cosentino, Nicola Tamborini, Gloria Celeste, Fabrizio Ianniruberto, Monica Ravagnani, Paolo Troiano, Sarah Marenzi, Giancarlo Pepi, Mauro Front Cardiovasc Med Cardiovascular Medicine AIMS: COVID-19 has dramatically impacted the healthcare system. Evidence from previous studies suggests a decline in in-hospital admissions for acute myocardial infarction (AMI) during the pandemic. However, the effect of the pandemic on mechanical complications (MC) in acute ST-segment elevation myocardial infarction (STEMI) has not been comprehensively investigated. Therefore, we evaluated the impact of the pandemic on MC and in-hospital outcomes in STEMI during the second wave, in which there was a huge SARS-CoV-2 diffusion in Italy. METHODS AND RESULTS: Based on a single center cohort of AMI patients admitted with STEMI between February 1, 2019, and February 28, 2021, we compared the characteristics and outcomes of STEMI patients treated during the pandemic vs. those treated before the pandemic. In total, 479 STEMI patients were included, of which 64.5% were during the pandemic. Relative to before the pandemic, primary percutaneous coronary intervention (PCI) declined (87.7 vs. 94.7%, p = 0.014) during the pandemic. Compared to those admitted before the pandemic (10/2019 to 2/2020), STEMI patients admitted during the second wave (10/2020 to 2/2021) presented with a symptom onset-to-door time greater than 24 h (26.1 vs. 10.3%, p = 0.009) and a reduction of primary PCI (85.2 vs. 97.1%, p = 0.009). MC occurred more often in patients admitted during the second wave of the pandemic than in those admitted before the pandemic (7.0 vs. 0.0%, p = 0.032). In-hospital mortality increased during the second wave (10.6 vs. 2.9%, p = 0.058). CONCLUSION: Although the experience gained during the first wave and a more advanced hub-and-spoke system for cardiovascular emergencies persists, late hospitalizations and a high incidence of mechanical complications in STEMI were observed even in the second wave. Frontiers Media S.A. 2022-10-03 /pmc/articles/PMC9573996/ /pubmed/36262205 http://dx.doi.org/10.3389/fcvm.2022.950952 Text en Copyright © 2022 Penso, Frappampina, Cosentino, Tamborini, Celeste, Ianniruberto, Ravagnani, Troiano, Marenzi and Pepi. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Cardiovascular Medicine
Penso, Marco
Frappampina, Antonio
Cosentino, Nicola
Tamborini, Gloria
Celeste, Fabrizio
Ianniruberto, Monica
Ravagnani, Paolo
Troiano, Sarah
Marenzi, Giancarlo
Pepi, Mauro
Outcomes and mechanical complications of acute myocardial infarction during the second wave pandemic in a Milan HUB center for cardiac emergencies
title Outcomes and mechanical complications of acute myocardial infarction during the second wave pandemic in a Milan HUB center for cardiac emergencies
title_full Outcomes and mechanical complications of acute myocardial infarction during the second wave pandemic in a Milan HUB center for cardiac emergencies
title_fullStr Outcomes and mechanical complications of acute myocardial infarction during the second wave pandemic in a Milan HUB center for cardiac emergencies
title_full_unstemmed Outcomes and mechanical complications of acute myocardial infarction during the second wave pandemic in a Milan HUB center for cardiac emergencies
title_short Outcomes and mechanical complications of acute myocardial infarction during the second wave pandemic in a Milan HUB center for cardiac emergencies
title_sort outcomes and mechanical complications of acute myocardial infarction during the second wave pandemic in a milan hub center for cardiac emergencies
topic Cardiovascular Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9573996/
https://www.ncbi.nlm.nih.gov/pubmed/36262205
http://dx.doi.org/10.3389/fcvm.2022.950952
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