Tạp chí Tim mạch học Việt Nam

Article detail

Article detail description

Home
NGHIÊN CỨU LÂM SÀNG Issue: Số 111

Mortality and major cardiovascular events during hospital stay in patients with ST segment elevation acute myocardial infarction during the COVID-19 epidemic period at Vietnam National Heart Institute, Bach Mai Hospital

Khổng Nam Hương: Viện Tim mạch Việt Nam, Bệnh viện Bạch Mai; Đinh Thị Anh: Trường Đại học Y Hà Nội; Phạm Mạnh Hùng: Viện Tim mạch Việt Nam, Bệnh viện Bạch Mai; Nguyễn Ngọc Quang: Trường Đại học Y Hà Nội; Tạ Mạnh Cường: Viện Tim mạch Việt Nam, Bệnh viện Bạch Mai;
Published: August 31, 2024
Views: 176

Abstract

Objective: Hospitalization rate and the door-to-balloon time in STEMI patients during the COVID-19 epidemic period at Vietnam National Heart Institute, Bach Mai Hospital and survey the mortality rate and major cardiovascular events during hospital stay in the above patients. Methods: Retrospective study on 929 patients with ST-segment elevation acute myocardial infarction first diagnosed at Vietnam National Heart Institute, Bach Mai Hospital from January 1, 2019 to December 31, 2021. These patients are divided into two groups: the pre-COVID-19 group (2019) and the COVID-19 epidemic group (2020 and 2021). Comparison characteristics of hospitalized STEMI patients during the COVID-19 outbreak with those of STEMI hospitalized during the corresponding time period in 2019. Primary outcomes included mortality and other outcomes  major cardiovascular events during hospital stay in a group of hospitalized STEMI patients during the COVID-19 outbreak.Results: There were 350 patients hospitalized in 2020, an increase of 18.2% compared to the number of hospitalizations in 2019. 283 patients hospitalized in 2021, a decrease of 4.4% compared to the number of hospitalizations in 2019. The wave of epidemics taking place in the months of April, August, September, October of 2020 and July, August, September of 2021 made the number of STEMI hospitalized cases lower than the corresponding months of 2019. The mean door-to-balloon time and ischemic time of the group during the COVID-19 epidemic period were 14.6 hours and 37.9 hours, respectively, longer than the group before the COVID-19 period, respectively, 10.1 hours and 31.5 hours, the difference is statistically significant, p<0.05. The rate of mechanical complications in the group of patients during the COVID-19 epidemic period was higher than the pre-COVID-19 period (4,4% vs 1.4%, p=0.008). There were no differences in mortality, severe heart failure, or dangerous arrhythmias between the two groups before and during the COVID-19 outbreak.Conclusion: The distribution of STEMI patients hospitalized during the peak months of the COVID-19 period decreased compared with the corresponding months of the pre-epidemic period, prolongation of the door-to-balloon time, the time of myocardial ischemia, and an increase in the rate of mechanical complications in hospitalized STEMI patients during the COVID-19 outbreak compared with that in the previous year. However, the rates of death, severe heart failure, and dangerous arrhythmias have not been found to be significantly different compared to the period before the COVID-19 epidemic.

References

1.
McNamara RL, Wang Y, Herrin J, et al. Effect of door-to-balloon time on mortality in patients with ST-segment elevation myocardial infarction. J Am Coll Cardiol. 2006;47(11):2180-2186. doi:10.1016/j.jacc.2005.12.072
2.
Berger PB, Ellis SG, Holmes DR Jr, et al. Relationship between delay in performing direct coronary angioplasty and early clinical outcome in patients with acute myocardial infarction: results from the global use of strategies to open occluded arteries in Acute Coronary Syndromes (GUSTO-IIb) trial. Circulation. 1999;100(1):14-20. doi:10.1161/01.cir.100.1.14
3.
Braiteh N, Rehman WU, Alom M, et al. Decrease in acute coronary syndrome presentations during the COVID-19 pandemic in upstate New York. Am Heart J. 2020;226:147-151. doi:10.1016/j.ahj.2020.05.009
4.
Leng WX, Yang JG, Li XD, et al. Impact of the shift to a fibrinolysis-first strategy on care and outcomes of patients with ST-segment-elevation myocardial infarction during the COVID-19 pandemic-The experience from the largest cardiovascular-specific centre in China. Int J Cardiol. 2021;329:260-265. doi:10.1016/j.ijcard.2020.11.074
5.
Mafham MM, Spata E, Goldacre R, et al. COVID-19 pandemic and admission rates for and management of acute coronary syndromes in England. Lancet. 2020;396(10248):381-389. doi:10.1016/S0140-6736(20)31356-8
6.
Pessoa-Amorim G, Camm CF, Gajendragadkar P, et al. Admission of patients with STEMI since the outbreak of the COVID-19 pandemic: a survey by the European Society of Cardiology. Eur Heart J Qual Care Clin Outcomes. 2020;6(3):210-216. doi:10.1093/ehjqcco/qcaa046
7.
Fardman A, Zahger D, Orvin K, et al. Acute myocardial infarction in the Covid-19 era: Incidence, clinical characteristics and in-hospital outcomes—A multicenter registry. PLoS One. 2021;16(6):e0253524. doi:10.1371/journal.pone.0253524
8.
Tam CCF, Cheung KS, Lam S, et al. Impact of Coronavirus Disease 2019 (COVID-19) Outbreak on ST-Segment–Elevation Myocardial Infarction Care in Hong Kong, China. Circ Cardiovasc Qual Outcomes. 2020;13(4):CIRCOUTCOMES.120.006631. doi:10.1161/CIRCOUTCOMES.120.006631

Files

Article Views176
Document Views0
Downloads0
Section NGHIÊN CỨU LÂM SÀNG
Issue Số 111