Coronary intervention in myocardial infarction during SARS-COVID-19 epidemic

█ Original article

DOI: 10.26430/CHUNGARICA.2023.53.1.37

Authors:
Voith László, Édes István Ferenc, Zima Endre,
Szigethy Tímea, Skoda Réka, Becker Dávid,
Merkely Béla
Semmelweis Egyetem, Városmajori Szív- és Érgyógyászati Klinika, Budapest

Levelezési cím:
Dr. Voith László, 1125 Budapest Diós árok 35/A,
e-mail: lvoith@gmail.com

Summary

Aim of the study: Treatment data comparison of the acute ST-elevation and non-ST-elevation myocardial infarction patients admitted to their intervention center at the peak of the 2nd and 3rd waves of the SARS-COVID-19 epidemic with those of the same calendar period one year earlier.
Results: The number of ST-elevation infarction cases undergoing intervention was essentially the same (234 versus 236) in the two periods, while the number of non-ST-elevation infarction cases decreased significantly (309 versus 229, p=0.0001). Compared to the control period, number of those requiring respiratory assistance increased non-significantly (8.7 versus 12.3%), while the number of those requiring circulatory assistance was the same, 1.7% in both groups. Need of acute or delayed coronary artery surgery became necessary in almost the same proportion in both periods (2.3 versus 2.6%). The 30-day mortality rate increased in all enrolled patients with infarcts during the epidemic period (9.3 versus 16.5%, p=0.003). For those who underwent the coronary intervention, difference was not statistically significant (9.0 versus 13.4%), for those who did not undergo the intervention, the ratio was significantly different (11.3 versus 39.7%). Compared to the control period, the annual total mortality during the epidemic was higher for all patients with infarction (19.0 versus 24.4%, p=0.03).
Discussion: During SARS-COVID-19 epidemic, the number of admitted acute myocardial infarction patients decreased significantly, probably the reason for this was the diminished number of non-ST elevation cases. In part, this may be the reason for the higher 30-day and one-year mortality rates of all admitted patients too. The sub-intervals of the time from the onset of complaints to the opening of the balloon did not differ significantly in the two periods, neither until admission to the interventional center nor until the opening of the balloon. For all cases, the number of primary interventions decreased significantly, but not for ST elevation infarctions. The rate of assisted breathing increased during the period of epidemic, but did not reach statistically significant values. The rates of assisted circulatory support and bypass surgery were essentially the same.

ISSUE: CARDIOLOGIA HUNGARICA | 2023 | VOLUME 53, ISSUE 1

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