The Incidence and Impact of In-Hospital Bleeding in Patients with Acute Coronary Syndrome during the COVID-19
Roberto Licordari1, Alessandro Sticchi2,3,4, Filippo Mancuso1
1Department of Clinical and Experimental Medicine, Policlinic "G Martino", University of Messina, 98124 Messina, Italy.
Insights
The COVID-19 pandemic did not change the rate of in-hospital bleeding in Acute Coronary Syndrome (ACS) patients. However, this bleeding significantly increased mortality risk both before and during the pandemic.
Area of Science:
- Cardiology
- Internal Medicine
- Epidemiology
Background:
- The COVID-19 pandemic complicated the management of Acute Coronary Syndrome (ACS).
- Understanding bleeding complications in ACS is crucial for patient outcomes.
Purpose of the Study:
- To investigate the incidence of in-hospital bleeding in ACS patients.
- To assess the prognostic impact of bleeding before and during the COVID-19 pandemic.
Main Methods:
- Retrospective analysis of 2851 ACS patients across 17 Italian centers.
- Comparison of bleeding events during March-April 2020 (COVID-19 wave) versus the same period in prior years.
- Evaluation of Thrombolysis In Myocardial Infarction (TIMI) major and minor bleeding.
Main Results:
- In-hospital bleeding incidence remained consistent before and during the COVID-19 pandemic.
- Bleeding events (TIMI major or minor) were associated with a threefold increase in all-cause mortality.
- The prognostic impact of bleeding on mortality was similar across both periods.
Conclusions:
- In-hospital bleeding incidence and its clinical impact in ACS patients were unchanged by the COVID-19 pandemic.
- In-hospital bleeding is a significant negative prognostic factor for ACS patients, independent of the pandemic.
Background:
The COVID-19 pandemic increased the complexity of the clinical management and pharmacological treatment of patients presenting with an Acute Coronary Syndrome (ACS).
Aim:
to explore the incidence and prognostic impact of in-hospital bleeding in patients presenting with ACS before and during the COVID-19 pandemic.
Methods:
We evaluated in-hospital Thrombolysis In Myocardial Infarction (TIMI) major and minor bleeding among 2851 patients with ACS from 17 Italian centers during the first wave of the COVID-19 pandemic (i.e., March-April 2020) and in the same period in the previous two years.
Results:
The incidence of in-hospital TIMI major and minor bleeding was similar before and during the COVID-19 pandemic. TIMI major or minor bleeding was associated with a significant threefold increase in all-cause mortality, with a similar prognostic impact before and during the COVID-19 pandemic.
Conclusions:
the incidence and clinical impact of in-hospital bleeding in ACS patients was similar before and during the COVID-19 pandemic. We confirmed a significant and sizable negative prognostic impact of in-hospital bleeding in ACS patients.
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