Impact of the COVID-19 Pandemic on ST-Elevation Myocardial Infarction Management in Hunan Province, China: A
Liang Tang1, Zhao-Jun Wang1, Xin-Qun Hu1
1Department of Cardiology, The Second Xiangya Hospital of Central South University, Changsha, China.
Insights
The COVID-19 pandemic decreased ST-segment elevation myocardial infarction (STEMI) admissions and PCI procedures in China. However, STEMI care quality and in-hospital outcomes remained unaffected, indicating resilient healthcare services.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- The COVID-19 pandemic presented unprecedented challenges to healthcare systems globally.
- Investigating its impact on acute cardiovascular care, specifically ST-segment elevation myocardial infarction (STEMI), is crucial.
Purpose of the Study:
- To assess the effect of the COVID-19 pandemic on STEMI care in China.
- To evaluate changes in STEMI admissions, treatment strategies, and patient outcomes during the pandemic.
Main Methods:
- A multicenter, retrospective cohort study was conducted in Hunan province, China.
- STEMI patients treated during the COVID-19 era (Jan-Apr 2020) were compared to a pre-COVID-19 era group (Jan-Apr 2019).
- Key quality indicators and in-hospital outcomes were analyzed.
Main Results:
- A 10.5% decline in STEMI admissions and a 12.7% decrease in STEMI-related PCI procedures were observed during the COVID-19 era.
- No significant differences were found in critical time intervals (e.g., door-to-balloon time) between the two periods.
- In-hospital death and major adverse cardiovascular events rates were similar in both groups.
Conclusions:
- While the COVID-19 pandemic led to a reduction in STEMI admissions and procedures, the quality of STEMI care was maintained.
- Healthcare system restructuring during the pandemic did not adversely impact in-hospital outcomes for STEMI patients.
Background:
This study aimed to investigate the impact of the COVID-19 pandemic on ST-segment elevation myocardial infarction (STEMI) care in China.
Methods:
We conducted a multicenter, retrospective cohort study in Hunan province (adjacent to the epidemic center), China. Consecutive patients presenting with STEMI within 12 h of symptom onset and receiving primary percutaneous coronary intervention, pharmaco-invasive strategy and only thrombolytic treatment, were enrolled from January 23, 2020 to April 8, 2020 (COVID-19 era group). The same data were also collected for the equivalent period of 2019 (pre-COVID-19 era group).
Results:
A total of 610 patients with STEMI (COVID-19 era group n = 286, pre-COVID-19 era group n = 324) were included. There was a decline in the number of STEMI admissions by 10.5% and STEMI-related PCI procedures by 12.7% in 2020 compared with the equivalent period of 2019. The key time intervals including time from symptom onset to first medical contact, symptom onset to door, door-to-balloon, symptom onset to balloon and symptom onset to thrombolysis showed no significant difference between these two groups. There were no significant differences for in-hospital death and major adverse cardiovascular events between these two groups.
Conclusion:
During the COVID-19 pandemic outbreak in China, we observed a decline in the number of STEMI admissions and STEMI-related PCI procedures. However, the key quality indicators of STEMI care were not significantly affected. Restructuring health services during the COVID-19 pandemic has not significantly adversely influenced the in-hospital outcomes.
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