Effect of Austrian COVID-19 lockdowns on acute myocardial infarction frequency and long-term mortality: a multicentre
Roya Anahita Mousavi1, Dominik Roth2, Christian Wallmüller1,3
1Karl Landsteiner Institute for Cardiovascular and Critical Care Research, Vienna, Austria.
Insights
Acute myocardial infarction (AMI) admissions decreased during COVID-19 lockdowns, but not equally across all periods. Early lockdown admission did not impact 1-year mortality rates for AMI patients.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Previous studies indicated a decrease in acute myocardial infarction (AMI) admissions during COVID-19 lockdowns.
- The impact of varying lockdown periods on AMI admissions and subsequent mortality requires further investigation.
Purpose of the Study:
- To determine if the reduction in AMI admissions during COVID-19 lockdowns (LD1, LD2, LD2021) was consistent across all periods.
- To analyze the association between decreased AMI admissions during lockdowns and 1-year mortality rates.
Main Methods:
- A prospective observational study included 1732 patients presenting with AMI between 2019 and 2021.
- Patients with myocardial infarction with non-obstructive coronary arteries were excluded.
- Primary outcomes included AMI frequency during lockdown periods and 1-year all-cause and cardiac mortality rates for 2019 and 2020.
Main Results:
- AMI admissions decreased by 55% in LD1, 28% in LD2, and 17% in LD2021 compared to 2019.
- Despite identical restrictions, the decrease in AMI admissions varied across lockdown periods.
- No significant difference was observed in 1-year all-cause mortality (11% in 2019 vs. 11% in 2020) or cardiac mortality (10% in 2019 vs. 10% in 2020).
Conclusions:
- All lockdown periods demonstrated a reduction in AMI admissions, though the extent varied.
- Admission during a lockdown period was not associated with increased 1-year all-cause or cardiac mortality in AMI patients.
Objectives:
The aim of this study was to find out if the decrease in acute myocardial infarction (AMI) admissions during the first COVID-19 lockdowns (LD), which was described by previous studies, occurred equally in all LD periods (LD1, LD2, LD2021), which had identical restrictions. Further, we wanted to analyse if the decrease of AMI admission had any association with the 1-year mortality rate.
Design And Setting:
This study is a prospective observational study of two centres that are participating in the Vienna ST-elevation myocardial infarction network.
Participants:
A total of 1732 patients who presented with AMI according to the 4th universal definition of myocardial infarction in 2019, 2020 and the LD period of 2021 were included in our study. Patients with myocardial infarction with non-obstructive coronary arteries were excluded from our study.
Main Outcome Measures:
The primary outcome of this study was the frequency of AMI during the LD periods and the all-cause and cardiac-cause 1-year mortality rate of 2019 (pre-COVID-19) and 2020.
Results:
Out of 1732 patients, 70% (n=1205) were male and median age was 64 years. There was a decrease in AMI admissions of 55% in LD1, 28% in LD2 and 17% in LD2021 compared with 2019.There were no differences in all-cause 1-year mortality between the year 2019 (11%; n=110) and 2020 (11%; n=79; p=0.92) or death by cardiac causes [10% (n=97) 2019 vs 10% (n=71) 2020; p=0.983].
Conclusion:
All LDs showed a decrease in AMI admissions, though not to the same extent, even though the regulatory measures were equal. Admission in an LD period was not associated with cardiac or all-cause 1-year mortality rate in AMI patients in our study.
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