The Effect of War on STEMI Incidence: Insights from Intensive Cardiovascular Care Unit Admissions
Ranel Loutati1, Sharon Bruoha2, Louay Taha1
1Jesselson Integrated Heart Center, The Eisenberg R&D Authority, Shaare Zedek Medical Center, The Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem 9112002, Israel.
Insights
The Israel-Hamas war saw fewer Arab patients and more ST-segment elevation myocardial infarction (STEMI) cases admitted to the intensive cardiovascular care unit (ICCU). In-hospital mortality rates remained similar between war and pre-war periods.
Area of Science:
- Cardiology
- Public Health
- War Studies
Background:
- Armed conflicts significantly impact public health, with psychological stress a known cardiovascular disease (CVD) risk factor.
- Limited contemporary data exist on war's influence on CVD, particularly acute coronary syndrome (ACS).
- This study assesses war's impact on ICCU admissions and patient prognosis.
Purpose of the Study:
- To evaluate the effect of the Israel-Hamas war on patient admissions to an intensive cardiovascular care unit (ICCU).
- To compare the characteristics and in-hospital mortality of patients admitted during the war versus the pre-war period.
- To understand the specific impact on different types of acute coronary syndrome (ACS).
Main Methods:
- Retrospective comparison of patients admitted to an ICCU during the first three months of the Israel-Hamas war (2023) and the same period in 2022.
- Primary outcome: in-hospital mortality.
- Analysis of patient demographics, admission diagnoses (STEMI vs. NSTEMI), and mortality rates.
Main Results:
- A total of 556 patients were analyzed; 53% were admitted during the war period.
- Fewer Arab patients and more ST-segment elevation myocardial infarction (STEMI) patients were admitted during the war.
- Non-STEMI admissions were more frequent in the pre-war year, while in-hospital mortality was similar between groups (4.4% vs. 3.4%).
Conclusions:
- The initial phase of the war altered patient demographics in the ICCU, with a decrease in Arab patients and an increase in STEMI cases.
- Despite demographic shifts, the war did not significantly impact in-hospital mortality for admitted cardiovascular patients.
- Findings highlight the need for continued research into the cardiovascular consequences of armed conflict.
Abstract:
(1) Background: The impact of armed conflicts on public health is undeniable, with psychological stress emerging as a significant risk factor for cardiovascular disease (CVD). Nevertheless, contemporary data regarding the influence of war on CVD, and especially on acute coronary syndrome (ACS), are scarce. Hence, the aim of the current study was to assess the repercussions of war on the admission and prognosis of patients admitted to a tertiary care center intensive cardiovascular care unit (ICCU). (2) Methods: All patients admitted to the ICCU during the first three months of the Israel-Hamas war (2023) were included and compared with all patients admitted during the same period in 2022. The primary outcome was in-hospital mortality. (3) Results: A total of 556 patients (184 females [33.1%]) with a median age of 70 (IQR 59-80) were included. Of them, 295 (53%) were admitted to the ICCU during the first three months of the war. Fewer Arab patients and more patients with ST-segment elevation myocardial infraction (STEMI) were admitted during the war period (21.8% vs. 13.2%, p < 0.001, and 31.9% vs. 24.1%, p = 0.04, respectively), whereas non-STEMI (NSTEMI) patients were admitted more frequently in the pre-war year (19.3% vs. 25.7%, p = 0.09). In-hospital mortality was similar in both groups (4.4% vs. 3.4%, p = 0.71; HR 1.42; 95% CI 0.6-3.32, p = 0.4). (4) Conclusions: During the first three months of the war, fewer Arab patients and more STEMI patients were admitted to the ICCU. Nevertheless, in-hospital mortality was similar in both groups.
More Related Videos
18:11A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
Published on: December 28, 2012
05:26Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction
Published on: May 28, 2019
Related Concept Videos
01:20Exercise and Cardiovascular Response
Light to moderate physical activity initiates a series of interconnected responses in the body. The heart rate modestly increases in anticipation of the workout, followed by widespread vasodilation as oxygen consumption by skeletal muscles increases. This results in decreased peripheral resistance, increased capillary blood flow, and accelerated...
01:17Ischemic Heart Disease: Overview
Atherosclerosis, the primary malefactor, orchestrates this dangerous condition. It manifests as the accumulation of fatty deposits, akin to insidious plaques, within arterial walls. As time elapses, these plaques metamorphose, hardening and...