Lauridsen M D, Butt J H, Østergaard L, Møller J E, Hassager C, Gerds T, Kragholm K, Phelps M, Schou M, Torp-Pedersen C, Gislason G, Køber L, Fosbøl E L
Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
Department of Cardiology, Odense University Hospital, Odense, Denmark.
Int J Cardiol Heart Vasc. 2020 Dec;31:100659. doi: 10.1016/j.ijcha.2020.100659. Epub 2020 Oct 13.
The hospitalization of patients with MI has decreased during global lockdown due to the COVID-19 pandemic. Whether this decrease is associated with more severe MI, e.g. MI-CS, is unknown. We aimed to examine the association of Corona virus disease (COVID-19) pandemic and incidence of acute myocardial infarction with cardiogenic shock (MI-CS).
On March 11, 2020, the Danish government announced national lock-down. Using Danish nationwide registries, we identified patients hospitalized with MI-CS. Incidence rates (IR) and incidence rate ratios (IRR) were used to compare MI-CS before and after March 11 in 2015-2019 and in 2020.
We identified 11,769 patients with MI of whom 696 (5.9%) had cardiogenic shock in 2015-2019. In 2020, 2132 MI patients were identified of whom 119 had cardiogenic shock (5.6%). The IR per 100,000 person years before March 11 in 2015-2019 was 9.2 (95% CI: 8.3-10.2) and after 8.9 (95% CI: 8.0-9.9). In 2020, the IR was 7.5 (95% CI: 5.8-9.7) before March 11 and 7.7 (95% CI: 6.0-9.9) after. The IRRs comparing the 2020-period with the 2015-2019 period before and after March 11 (lockdown) were 0.81 (95% CI: 0.59-1.12) and 0.87 (95% CI: 0.57-1.32), respectively. The IRR comparing the 2020-period during and before lockdown was 1.02 (95% CI: 0.74-1.41). No difference in 7-day mortality or in-hospital management was observed between study periods.
We could not identify a significant association of the national lockdown on the incidence of MI-CS, along with similar in-hospital management and mortality in patients with MI-CS.
在因新冠疫情导致的全球封锁期间，心肌梗死（MI）患者的住院率有所下降。这种下降是否与更严重的心肌梗死，如心源性休克型心肌梗死（MI-CS）有关尚不清楚。我们旨在研究冠状病毒病（COVID-19）大流行与急性心肌梗死合并心源性休克（MI-CS）的发病率之间的关联。
2020年3月11日，丹麦政府宣布全国封锁。利用丹麦全国性登记系统，我们确定了因MI-CS住院的患者。发病率（IR）和发病率比（IRR）用于比较2015 - 2019年以及2020年3月11日前后的MI-CS情况。
我们确定了11769例心肌梗死患者，其中2015 - 2019年有696例（5.9%）发生心源性休克。2020年，确定了2132例心肌梗死患者，其中119例发生心源性休克（5.6%）。2015 - 2019年3月11日之前每10万人年的发病率为9.2（95%可信区间：8.3 - 10.2），之后为8.9（95%可信区间：8.0 - 9.9）。2020年，3月11日之前的发病率为7.5（95%可信区间：5.8 - 9.7），之后为7.7（95%可信区间：6.0 - 9.9）。将2020年期间与2015 - 2019年期间3月11日（封锁）前后进行比较的发病率比分别为0.81（95%可信区间：0.59 - 1.12）和0.87（95%可信区间：0.57 - 1.32）。比较2020年封锁期间和之前的发病率比为1.02（95%可信区间：0.74 - 1.41）。各研究期间在7天死亡率或住院治疗方面未观察到差异。
我们未能确定全国封锁与MI-CS发病率之间存在显著关联，MI-CS患者的住院治疗和死亡率相似。
