Treatment delays and in-hospital outcomes in acute myocardial infarction during the COVID-19 pandemic: A nationwide study

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dc.contributor.authorErol, Mustafa Kemal
dc.contributor.authorKayıkçıoğlu, Meral
dc.contributor.authorKılıçkap, Mustafa
dc.contributor.authorGüler, Arda
dc.contributor.authorYıldırım, Abdullah
dc.contributor.authorKahraman, Fatih
dc.contributor.authorCan, Veysi
dc.date.accessioned2025-01-27T18:56:19Z
dc.date.available2025-01-27T18:56:19Z
dc.date.issued2020
dc.departmentÇanakkale Onsekiz Mart Üniversitesi
dc.description.abstractObjective: Delayed admission of myocardial infarction (MI) patients is an important prognostic factor. In the present nationwide registry (TURKMI-2), we evaluated the treatment delays and outcomes of patients with acute MI during the Covid-19 pandemic and compaired with a recent pre-pandemic registry (TURKMI-1). Methods: The pandemic and pre-pandemic studies were conducted prospectively as 15-day snapshot registries in the same 48 centers. The inclusion criteria for both registries were aged ?18 years and a final diagnosis of acute MI (AMI) with positive troponin levels. The only difference between the 2 registries was that the pre-pandemic (TURKMI-1) registry (n=1872) included only patients presenting within the first 48 hours after symptom-onset. TURKMI-2 enrolled all consecutive patients (n=1113) presenting with AMI during the pandemic period. Results: A comparison of the patients with acute MI presenting within the 48-hour of symptom-onset in the pre-pandemic and pandemic registries revealed an overall 47.1% decrease in acute MI admissions during the pandemic. Median time from symptom-onset to hospital-arrival increased from 150 min to 185 min in patients with ST elevation MI (STEMI) and 295 min to 419 min in patients presenting with non-STEMI (NSTEMI) (p-values <0.001). Door-to-balloon time was similar in the two periods (37 vs. 40 min, p=0.448). In the pandemic period, percutaneous coronary intervention (PCI) decreased, especially in the NSTEMI group (60.3% vs. 47.4% in NSTEMI, p<0.001; 94.8% vs. 91.1% in STEMI, p=0.013) but the decrease was not significant in STEMI patients admitted within 12 hours of symptom-onset (94.9% vs. 92.1%; p=0.075). In-hospital major adverse cardiac events (MACE) were significantly increased during the pandemic period [4.8% vs. 8.9%; p<0.001; age- and sex-adjusted Odds ratio (95% CI) 1.96 (1.20-3.22) for NSTEMI, p=0.007; and 2.08 (1.38-3.13) for STEMI, p<0.001]. Conclusion: The present comparison of 2 nationwide registries showed a significant delay in treatment of patients presenting with acute MI during the COVID-19 pandemic. Although PCI was performed in a timely fashion, an increase in treatment delay might be responsible for the increased risk of MACE. Public education and establishing COVID-free hospitals are necessary to overcome patients' fear of using healthcare services and mitigate the potential complications of AMI during the pandemic. © 2020 by Turkish Society of Cardiology.
dc.description.sponsorshipAstra-Zeneca Company; OpenClinica LLC
dc.identifier.doi10.14744/AnatolJCardiol.2020.98607
dc.identifier.issn2149-2263
dc.identifier.issue5
dc.identifier.pmid33122486
dc.identifier.scopus2-s2.0-85094935438
dc.identifier.scopusqualityQ3
dc.identifier.urihttps://doi.org/10.14744/AnatolJCardiol.2020.98607
dc.identifier.urihttps://hdl.handle.net/20.500.12428/12943
dc.identifier.volume24
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherTurkish Society of Cardiology
dc.relation.ispartofAnatolian Journal of Cardiology
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/openAccess
dc.snmzKA_Scopus_20250125
dc.subjectAcute myocardial infarction; COVID-19; Pandemic; Total ischemic time; Treatment delay
dc.titleTreatment delays and in-hospital outcomes in acute myocardial infarction during the COVID-19 pandemic: A nationwide study
dc.typeArticle

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