Petrović M, Milovančev A, Kovačević M, Miljković T, Ilić A, Stojšić-Milosavljević A, Golubović M
Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia.
Institute of Cardiovascular Diseases of Vojvodina, Sremska Kamenica, Serbia.
Neth Heart J. 2021 Apr;29(4):230-236. doi: 10.1007/s12471-021-01554-x. Epub 2021 Mar 11.
As coronavirus disease 2019 (COVID-19) has reached pandemic status, authors from the most severely affected countries have reported reduced rates of hospital admissions for patients with acute coronary syndrome (ACS).
The aim of the present study was to investigate the influence of the COVID-19 outbreak on hospital admissions and outcomes in ACS patients in a single high-volume centre in southeastern Europe.
This retrospective observational study aimed to investigate the number of hospital admissions for ACS, clinical findings at admission, length of hospitalisation, major complications and in-hospital mortality during the COVID-19 outbreak and to compare the data with the same parameters during an equivalent time frame in 2019. For the ST-elevated myocardial infarction (STEMI) subgroup of patients, changes in ischaemic times were analysed as well.
There was a significant reduction of 44.3% in the number of patients admitted for ACS during the COVID-19 outbreak when compared with the same period in 2019 (151 vs 271; 95% confidence interval 38.4-50.2, p < 0.01) with a higher mortality rate (13.2% vs 7.2%, p = 0.03). In 2020, patients with non-ST-elevated myocardial infarction presented more often with acute heart failure (3.3% vs 0.7%, p = 0.04). During the COVID-19 outbreak, we observed increases in the total ischaemic time (303 ± 163.4 vs 200.8 ± 156.8 min, p < 0.05) and door-to-balloon time (69.2 ± 58.4 vs 50.5 ± 31.3 min, p < 0.01) in STEMI patients.
These findings should increase the awareness of morbidity and mortality related to missed or delayed treatment of ACS among the public and the healthcare services.
随着2019冠状病毒病（COVID-19）成为大流行病，来自受影响最严重国家的作者报告称，急性冠状动脉综合征（ACS）患者的住院率有所下降。
本研究的目的是调查COVID-19疫情对欧洲东南部一个大型单一中心ACS患者住院情况及预后的影响。
这项回顾性观察性研究旨在调查COVID-19疫情期间ACS的住院人数、入院时的临床发现、住院时间、主要并发症和院内死亡率，并将这些数据与2019年同一时间段的相同参数进行比较。对于ST段抬高型心肌梗死（STEMI）亚组患者，还分析了缺血时间的变化。
与2019年同期相比，COVID-19疫情期间ACS住院患者数量显著减少了44.3%（151例对271例；95%置信区间38.4 - 50.2，p<0.01），死亡率更高（13.2%对7.2%，p = 0.03）。2020年，非ST段抬高型心肌梗死患者更常出现急性心力衰竭（3.3%对0.7%，p = 0.04）。在COVID-19疫情期间，我们观察到STEMI患者的总缺血时间（303±163.4分钟对200.8±156.8分钟，p<0.05）和门球时间（69.2±58.4分钟对50.5±31.3分钟，p<0.01）增加。
这些发现应提高公众和医疗服务机构对ACS漏诊或延迟治疗相关发病率和死亡率的认识。
