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Decrease in acute coronary syndrome presentations during the COVID-19 pandemic in upstate New York
Nabil Braiteh1, Wajeeh Ur Rehman2, Md Alom2
1United Health Services Hospitals, Heart and Vascular Institute, Wilson Regional Medical Center, Department of Cardiology, NY, USA.
Insights
The COVID-19 pandemic caused a 40.7% decrease in acute coronary syndrome (ACS) admissions. This reduction in care may lead to more heart attack complications in the future.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- The COVID-19 pandemic significantly impacted healthcare systems globally.
- Studies have indicated a notable decrease in acute coronary syndrome (ACS) admissions during the pandemic, with the reasons remaining unclear.
Purpose of the Study:
- To investigate the impact of the COVID-19 pandemic on acute coronary syndrome (ACS) admissions.
- To analyze changes in patient presentation and demographics for ACS during the pandemic compared to pre-pandemic periods.
Main Methods:
- A retrospective, multi-centered study was conducted in Upstate New York.
- Data from 180 patients with ACS (STEMI and NSTEMI) admitted in March/April 2019 (pre-pandemic) and March/April 2020 (during pandemic) were analyzed.
- Patient demographics, admission rates, and time to presentation were compared between the two periods.
Main Results:
- A significant drop of 40.7% in total ACS admissions was observed during the pandemic period (March/April 2020) compared to the same period in 2019 (P < .05).
- The proportion of NSTEMI patients presenting late ( >24 hours from symptom onset) increased during the pandemic (36.4%) compared to the pre-pandemic period (27.1%, P = .033).
- The mean age of patients presenting with ACS was higher during the pre-pandemic period (72.3 years) compared to the pandemic period (65.1 years).
Conclusions:
- The COVID-19 pandemic was associated with a substantial decrease in ACS admissions.
- The observed increase in late presentations for NSTEMI patients during the pandemic is a concerning trend.
- Reduced hospital admissions and delayed care for ACS during the pandemic may foreshadow an increase in future myocardial infarction complications.
Abstract:
The COVID-19 virus is a devastating pandemic that has impacted the US healthcare system significantly. More than one study reported a significant decrease in acute coronary syndrome admissions during that pandemic which is still due to unknown reasons.
Methods:
This is a retrospective non-controlled multi-centered study of 180 patients (117 males and 63 females) with acute coronary syndrome (STEMI and NSTEMI) admitted during March/April of 2019 and March/April 2020 in Upstate New York.
Results:
A total of 113 patients (61.9% males, 38.1% females) with a mean age of 72.3 ± 14.2 presented during March/April 2019 with ACS (STEMI + NSTEMI) while only 67 (70.1% males, 29.9% females) COVID-19 negative patients with a mean age of 65.1 ± 14.5 presented during the same period (March/April) in 2020. This is a drop by 40.7% (P < .05) of total ACS cases during the COVID-19 pandemic. In NSTEMI patients, 36.4% presented late (>24 hours of symptoms) during the COVID-19 pandemic in comparison with 2019 (27.1%, P = .033).
Conclusion:
The COVID-19 pandemic led to a substantial drop by 40.7% (P < .05) of total ACS admissions in our area. This decrease in hospital admissions and late presentations can be a worrisome sign for an increase in future complications of myocardial infarctions.
