Bruoha Sharon, Stolichny Tatiana, Chitoroga Vladimir, Shilo Michael, Friger Michael, Jafari Jamal, Chernogoz Evgeny, Grisaru Maggie Cohen, Katz Amos, Yosefy Chaim, Givaty Gili
Department of Cardiology, Barzilai University Medical Center, Ashkelon and Faculty of Health Science, Ben-Gurion University of the Negev, Israel.
Department of Epidemiology, Biostatistics and Community Health, Faculty of Health Science, Ben-Gurion University of the Negev, Israel.
Heliyon. 2024 Dec 12;11(1):e41172. doi: 10.1016/j.heliyon.2024.e41172. eCollection 2025 Jan 15.
Contemporary data regarding the impact of war on cardiovascular disease is scarce. The Israel-Gaza war that erupted on October 7th, 2023, provided a tragic opportunity to explore the effect of war on the epidemiology, characteristics, and management of patients with acute coronary syndrome (ACS) living in areas of active armed conflict.
All patients admitted with ACS to our medical center, between October 7th, 2023, and January 6th, 2024, were retrospectively included. Crucial time intervals in the management of individuals with ACS were collected in a predetermined spreadsheet. In-hospital and 30-day outcomes were obtained from the medical records and contrasted with ACS cases admitted in the period preceding the war.
A total of 449 individuals (102 females [22.7 %]) with a diagnosis of ACS were recruited, 358 patients (144 STEMI and 214 NSTEMI) were admitted during the 9 months before October 7th and 91 patients (42 STEMI and 49 NSTEMI) in the 3 months after October 7th. Compared to the control period, a significant reduction in ACS admissions per month was noted (38.91 vs. 28.79, p < 0.001) driven by fewer cases of both STEMI and NSTEMI (15.65 vs. 13.29, p = 0.011 and 23.26 vs. 15.5, p < 0.001, respectively). In patients with STEMI, the total ischemic time was similar before and after the war (179 min vs. 187 min, p = 0.849).
War has a dramatic impact on cardiovascular incidence and outcomes which, however, are not necessarily linked to higher admission rates. Nevertheless, with the adoption of systematic approach and increased awareness, patients with ACS can be managed effectively even at times of extremely limited resources such as war.
关于战争对心血管疾病影响的当代数据稀缺。2023年10月7日爆发的以色列-加沙战争提供了一个悲惨的机会，以探讨战争对生活在武装冲突活跃地区的急性冠状动脉综合征（ACS）患者的流行病学、特征及治疗的影响。
回顾性纳入2023年10月7日至2024年1月6日期间因ACS入住我们医疗中心的所有患者。在预先设定的电子表格中收集ACS患者治疗过程中的关键时间间隔。从病历中获取住院期间及30天的结局，并与战争前同期收治的ACS病例进行对比。
共招募了449例诊断为ACS的患者（102例女性[22.7%]），10月7日前的9个月内收治358例患者（144例ST段抬高型心肌梗死和214例非ST段抬高型心肌梗死），10月7日后的3个月内收治91例患者（42例ST段抬高型心肌梗死和49例非ST段抬高型心肌梗死）。与对照期相比，每月ACS入院人数显著减少（38.91对28.79，p<0.001），这是由ST段抬高型心肌梗死和非ST段抬高型心肌梗死病例数减少所致（分别为15.65对13.29，p=0.011；23.26对15.5，p<0.001）。在ST段抬高型心肌梗死患者中，战争前后的总缺血时间相似（179分钟对187分钟，p=0.849）。
战争对心血管疾病的发病率和结局有巨大影响，然而，这不一定与更高的入院率相关。尽管如此，通过采用系统方法并提高认识，即使在战争等资源极其有限的时期，ACS患者也能得到有效治疗。
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