Outcomes and management of ST-Elevation myocardial infarction patients before and during the COVID-19 pandemic: A retrospective cohort study
- Author:
Miguel Angelo D. Ang Co
1
;
Rhandy P. Panganiban
1
Author Information
- Publication Type:Journal Article
- Keywords: ACS management
- MeSH: ST Elevation Myocardial Infarction; COVID-19
- From: Philippine Journal of Internal Medicine 2023;61(4):193-200
- CountryPhilippines
- Language:English
-
Abstract:
Background:Ischemic heart disease is the leading cause of mortality and morbidity worldwide. The COVID-19 pandemic changed healthcare-seeking behavior and healthcare delivery.
Methods:This is a single-center, retrospective cohort study using a non-probability sampling of adult patients at the Philippine Heart Center who were diagnosed with ACS-STEMI. Baseline characteristics, clinical profile, management plan, and outcomes of patients were determined and analyzed in both periods.
Results:170 STEMI patients during each period were included in the study. The mean time for the onset of symptoms to consult was 8 hours in both periods. Majority of STEMI patient had undergone primary PCI in both periods. There is a significant decline in the number of patients undergoing primary PCI during the COVID 19 period (n=116, 68%). Fibrinolysis was performed more during the COVID 19 pandemic (n=9, 5%) and none in the pre-COVID 19 period. There was a statistically significant delay in the door-to-wiring time during the pandemic. Composite outcome was significantly higher during this time with 42 patients (25%, p=0.029). Composite outcomes were also higher in STEMI patients with COVID-19 infection (OR 1.9, 95% CI 1.0989 - 3.2960, p=0.022).
Conclusion:The study confirmed that there was an increase in the rate of fibrinolysis and medical therapy alone during the COVID-19 period. There was also a significant delay in the door-to-wiring time as well as an increase in composite outcomes during the COVID-19 pandemic. - Full text:PJIM 110.pdf
