Santos MM, Prohías MJA, Martínez GG, Gómez FMJ, Prieto GM, Blanco PY, Rodríguez RMA

Language: Spanish
References: 23
Page: 1-8
PDF size: 568.04 Kb.

ABSTRACT

Introduction: The clinico-epidemiological characteristics in the diagnosis, evolution and treatment of patients with acute myocardial infarction in the COVID-19 era depend on several factors.
Objectives: To determine the behavior of some clinico-epidemiological variables in the management of patients with acute myocardial infarction during de COVID-19 pandemic.
Methods: An observational study was carried out in four secondary care hospitals in Cuba. The following variables were used: number of admission due to acute myocardial infarction, hospital mortality, delay longer than four hours from the beginning of the symptoms to the arrival to the first medical assistance, and thrombolysis percentage. Two groups were defined, those admitted from March 1st to September 30th, 2019 (Group I) and those admitted in the same period, but from 2020 (Group II). Comparisons between both groups were made using the chi square test.
Results: There was a decrease of 53 admissions due to acute myocardial infarction in Las Tunas (112 vs. 159; p<0.05), with an increase in the number of admissions in the Hospital Enrique Cabrera in patients from Group II (98 vs. 68; p<0.05). The number of deaths and hospital mortality in Group II increased in all the centers in relation to Group I. In most of the hospitals there was an increase of the time elapsed from the beginning of the symptoms to the arrival to the first medical assistance. Thrombolysis percentage in Group II was higher than 50% in most of the centers.
Conclusions: The characteristics of COVID-19 may modify the clinical and epidemiological aspects in the management of patients with acute myocardial infarction.

REFERENCES

1. Mahmud E, Dauerman HL, Welt FG, Messenger JC, Rao SV, Grines C, et al. Management of Acute Myocardial Infarction During the COVID-19 Pandemic: A Position Statement from the Society for Cardiovascular Angiography and Interventions (SCAI), the American College of Cardiology (ACC), and the American College of Emergency Physicians (ACEP). J Am Coll Cardiol. 2020;76(11):1375-84. DOI: https://doi.org/10.1016/j.jacc.2020.04.039

2. Coughlan JJ, Chongprasertpon N, Arockiam S, Arnous S, Kiernan TJ. COVID-19 and STEMI: A snapshot analysis of presentation patterns during a pandemic. Int J Cardiol Heart Vasc [Internet]. 2020 [citado 22/10/2020];30:100546. Disponible en: https://doi.org/10.1016/j.ijcha.2020.100546

3. World Health Organization. WHO Coronavirus Disease (COVID-19) Dashboard. Ginebra: WHO Health Emergency Dashboard [Internet]. 2020 [citado 22/10/2020]. Disponible en: https://covid19.who.int

4. Ranard LS, Parikh SA, Kirtane AJ. COVID-19-Specific strategies for the treatment of ST-segment elevation myocardial infarction in China. J Am Coll Cardiol. 2020;76(11):1325-7. DOI: https://doi.org/10.1016/j.jacc.2020.07.054

5. Cosentino N, Assanelli E, Merlino L, Mazza M, Bartorelli AL, Marenzi G. An in-hospital pathway for acute coronary syndrome patients during the COVID-19 Outbreak: Initial experience under real-world suboptimal conditions. Can J Cardiol. 2020;36(6):961-4. DOI: https://doi.org/10.1016/j.cjca.2020.04.011

6. Ebinger JE, Shah PK. Declining admissions for acute cardiovascular illness: The COVID-19 Paradox. J Am Coll Cardiol. 2020;76(3):289-91. DOI: https://doi.org/10.1016/j.jacc.2020.05.039

7. Bhatt AS, Moscone A, McElrath EE, Varshney AS, Claggett BL, Bhatt DL, et al. Fewer hospitalizations for acute cardiovascular conditions during the COVID-19 pandemic. J Am Coll Cardiol. 2020;76(3):280-8. DOI: https://doi.org/10.1016/j.jacc.2020.05.038

8. Atri D, Siddiqi HK, Lang JP, Nauffal V, Morrow DA, Bohula EA. COVID-19 for the Cardiologist: Basic virology, epidemiology, cardiac manifestations, and potential therapeutic strategies. JACC Basic Transl Sci. 2020;5(5):518-36. DOI: https://doi.org/10.1016/j.jacbts.2020.04.002

9. Zhou F, Yu T, Du R, Fan G, Liu Y, Lui Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395(10229):1054-62. DOI: https://doi.org/10.1016/s0140-6736(20)30566-3

10. Guo T, Fan Y, Chen M, Wu X, Zhang L, He T, et al. Cardiovascular implications of fatal outcomes of patients with coronavirus disease 2019 (COVID-19). JAMA Cardiol. 2020;5(7):811-8. DOI: https://doi.org/10.1001/jamacardio.2020.1017

11. De Rosa S, Spaccarotella C, Basso C, Calabró MP, Curcio A, Filardi PP, et al. Reduction of hospitalizations for myocardial infarction in Italy in the COVID-19 era. Eur Heart J. 2020;41(22):2083-8. DOI: https://doi.org/10.1093/eurheartj/ehaa409

12. De Filippo O, D'Ascenzo F, Angelini F, Bocchino PP, Conrotto F, Saglietto A, et al. Reduced rate of hospital admissions for ACS during covid-19 outbreak in Northern Italy. N Engl J Med. 2020;383(1):88-9. DOI: https://doi.org/10.1056/nejmc2009166

13. García S, Albaghdadi MS, Meraj PM, Schmidt C, Garberich R, Jaffer FA, et al. Reduction in ST-segment elevation cardiac catheterization laboratory activations in the United States during COVID-19 pandemic. J Am Coll Cardiol. 2020;75(22):2871-2. DOI: https://doi.org/10.1016/j.jacc.2020.04.011

14. Santos Medina M, Rodríguez Ramos M, Prohias Martínez J, Ochoa Montes LA, Dueñas Herrera A, de Lara Abad J. Bases metodológicas del registro cubano de infarto agudo del miocardio: de la utopía a la realidad. Rev Cuban Cardiol [Internet]. 2018 [citado 8/11/2020];24(2). Disponible en: http://www.revcardiologia.sld.cu/index.php/revcardiologia/article/view/741/pdf_131

15. Rattka M, Baumhardt M, Dreyhaupt J, Rothenbacher D, Thiessen K, Markovic S, et al. 31 days of COVID-19-cardiac events during restriction of public life - A comparative study. Clin Res Cardiol. 2020;109(12):1476-82. DOI: https://doi.org/10.1007/s00392-020-01681-2

16. Secco GG, Zocchi C, Parisi R, Roveta A, Mirabella F, Vercellino M, et al. Decrease and delay in hospitalization for acute coronary syndromes during the 2020 SARS-CoV-2 pandemic. Can J Cardiol. 2020;36(7):1152-5. DOI: https://doi.org/10.1016/j.cjca.2020.05.023

17. Xiang D, Xiang X, Zhang W, Yi S, Zhang J, Gu X, et al. Management and outcomes of patients with STEMI during the COVID-19 pandemic in China. J Am Coll Cardiol. 2020;76(11):1318-24. DOI: https://doi.org/10.1016/j.jacc.2020.06.039

18. Braiteh N, Rehman W, Alom M, Skovira V, Breiteh N, Rehman I, et al. Decrease in acute coronary syndrome presentations during the COVID-19 pandemic in upstate New York. Am Heart J. 2020;226:147-51. DOI: https://doi.org/10.1016/j.ahj.2020.05.009

19. Metzler B, Siostrzonek P, Binder RK, Bauer A, Reinstadler SJ. Decline of acute coronary syndrome admissions in Austria since the outbreak of COVID-19: the pandemic response causes cardiac collateral damage. Eur Heart J. 2020;41(19):1852-3. DOI: https://doi.org/10.1093/eurheartj/ehaa314

20. Showkathali R, Yalamanchi R, Sankeerthana MP, Kumaran SN, Shree S, Nayak R, et al. Acute coronary syndrome admissions and outcome during COVID-19 pandemic - Report from large tertiary centre in India. Indian Heart J. 2020;72(6)599-602. DOI: https://doi.org/10.1016/j.ihj.2020.09.005

21. Toner L, Koshy AN, Hamilton GW, Clark D, Farouque O, Yudi MB. Acute coronary syndromes undergoing percutaneous coronary intervention in the COVID-19 era: comparable case volumes but delayed symptom onset to hospital presentation. Eur Heart J Qual Care Clin Outcomes. 2020;6(3):225-6. DOI: https://doi.org/10.1093/ehjqcco/qcaa038

22. Mafham MM, Spata E, Goldacre R, Gair D, Curnow P, Bray M, et al. COVID-19 pandemic and admission rates for and management of acute coronary syndromes in England. Lancet. 2020;396(10248):381-9. DOI: https://doi.org/10.1016/S0140-6736(20)31356-8

23. Roffi M, Capodanno D, Windecker S, Baumbach A, Dudek D. Impact of the COVID-19 pandemic on interventional cardiology practice: Results of the EAPCI survey. EuroIntervention. 2020;16(3):247-50. DOI: https://doi.org/10.4244/EIJ-D-20-00528