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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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2021-02-01
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| Series: | Open Heart |
| Online Access: | https://openheart.bmj.com/content/8/1/e001497.full |
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| author | Hisao Ogawa Kunihiro Nishimura Kenichi Tsujita Yoshio Tahara Daisuke Onozuka Tomoyuki Fujita Satoshi Kitahara Masashi Fujino Satoshi Honda Yasuhide Asaumi Yu Kataoka Fumiyuki Otsuka Michio Nakanishi Soshiro Ogata |
| author_facet | Hisao Ogawa Kunihiro Nishimura Kenichi Tsujita Yoshio Tahara Daisuke Onozuka Tomoyuki Fujita Satoshi Kitahara Masashi Fujino Satoshi Honda Yasuhide Asaumi Yu Kataoka Fumiyuki Otsuka Michio Nakanishi Soshiro Ogata |
| author_sort | Hisao Ogawa |
| collection | DOAJ |
| 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. |
| format | Article |
| id | doaj-art-e4eae91c68d1439b84f2ee80f4c183b1 |
| institution | OA Journals |
| issn | 2053-3624 |
| language | English |
| publishDate | 2021-02-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | Open Heart |
| spelling | doaj-art-e4eae91c68d1439b84f2ee80f4c183b12025-08-20T02:14:11ZengBMJ Publishing GroupOpen Heart2053-36242021-02-018110.1136/openhrt-2020-001497COVID-19 pandemic is associated with mechanical complications in patients with ST-elevation myocardial infarctionHisao Ogawa0Kunihiro Nishimura1Kenichi Tsujita2Yoshio Tahara3Daisuke Onozuka4Tomoyuki Fujita5Satoshi Kitahara6Masashi Fujino7Satoshi Honda8Yasuhide Asaumi9Yu Kataoka10Fumiyuki Otsuka11Michio Nakanishi12Soshiro Ogata13Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, JapanDepartment of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita, JapanDepartment of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan4 National Cerebral and Cardiovascular Center Hospital, Suita, JapanDepartment of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita, JapanDepartment of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, JapanDepartment of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, JapanDepartment of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, JapanDepartment of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, JapanDepartment of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, JapanDepartment of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, JapanDepartment of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, JapanDepartment of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Osaka, JapanPreventive Medicine & Epidemiology, National Cerebral and Cardiovascular Center, Suita, Osaka, JapanObjective 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.https://openheart.bmj.com/content/8/1/e001497.full |
| spellingShingle | Hisao Ogawa Kunihiro Nishimura Kenichi Tsujita Yoshio Tahara Daisuke Onozuka Tomoyuki Fujita Satoshi Kitahara Masashi Fujino Satoshi Honda Yasuhide Asaumi Yu Kataoka Fumiyuki Otsuka Michio Nakanishi Soshiro Ogata COVID-19 pandemic is associated with mechanical complications in patients with ST-elevation myocardial infarction Open Heart |
| 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 |
| url | https://openheart.bmj.com/content/8/1/e001497.full |
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