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The bimodal "rise and fall" ACS curve overlapping COVID-19 pandemic peaks

Daniela Trabattoni1, Paolo M Ravagnani1, Luca Merlino1

  • 1Centro Cardiologico Monzino, IRCCS Milan, Italy.

American Journal of Cardiovascular Disease
|July 29, 2021
PubMed

Insights

The COVID-19 pandemic caused a 55% rise in ST-elevation myocardial infarction (STEMI) cases, leading to delayed treatment and doubled mortality rates. Prompt STEMI diagnosis and treatment are crucial, even during global crises.

Area of Science:

  • Cardiology
  • Public Health
  • Epidemiology

Background:

  • The COVID-19 pandemic significantly impacted acute coronary syndromes (ACS) care.
  • National lockdowns in Italy led to patient delays in seeking medical help due to contagion fears, particularly for ST-elevation myocardial infarction (STEMI).

Purpose of the Study:

  • To evaluate ACS admissions, time to presentation, and clinical outcomes during the pandemic year 2020.
  • Comparison of ACS patient data from 2020 with a historical cohort from 2019 at a Milan cardiovascular hub.

Main Methods:

  • Retrospective analysis of hospital database records for ACS patients.
  • Comparison of patient cohorts admitted in 2020 (pandemic) versus 2019.

Main Results:

  • A 55% increase in ACS cases was observed in 2020 (599 cases) compared to 2019 (386 cases).
  • Late clinical presentations were associated with a threefold increase in cardiogenic shock.
  • Mortality rates for ACS patients more than doubled in 2020 compared to 2019.

Conclusions:

  • The study highlights the severe consequences of delayed STEMI diagnosis and treatment during the COVID-19 crisis.
  • Emphasizes the critical need for maintaining universal and prompt STEMI care protocols, irrespective of global health emergencies.
Abstract

Keywords:
ACSCOVID-19 outbreakSTEMIlate presentation

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