Research Article
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Year 2020, , 473 - 478, 31.12.2020
https://doi.org/10.7197/cmj.814394

Abstract

References

  • 1. Thygesen K, Alpert JS, Jaffe AS, Chaitman BR, Bax JJ, Morrow DA, White HD; Executive Group on behalf of the Joint European Society of Cardiology (ESC)/American College of Cardiology (ACC)/American Heart Association (AHA)/World Heart Federation (WHF) Task Force for the Universal Definition of Myocardial Infarction. Fourth Universal Definition of Myocardial Infarction (2018). Glob Heart 2018; 13: 305-38. doi: 10.1016/j.gheart.2018.08.004.
  • 2. Vecchio S, Fileti L, Reggi A, Moschini C, Lorenzetti S, Rubboli A. Impatto della pandemia COVID-19 sui ricoveri per sindrome coronarica acuta: revisione della letteratura ed esperienza monocentrica [Impact of the COVID-19 pandemic on admissions for acute coronary syndrome: review of the literature and single-center experience]. G Ital Cardiol (Rome) 2020; 21: 502-8. doi: 10.1714/3386.33635.
  • 3. De Rosa S, Spaccarotella C, Basso C, Calabrò MP, Curcio A, Filardi PP, Mancone M, Mercuro G, Muscoli S, Nodari S, Pedrinelli R, Sinagra G, Indolfi C; Società Italiana di Cardiologia and the CCU Academy investigators group. Reduction of hospitalizations for myocardial infarction in Italy in the COVID-19 era. Eur Heart J 2020 ; 41: 2083-8. doi: 10.1093/eurheartj/ehaa409.
  • 4. Di Liberto IA, Pilato G, Geraci S, Milazzo D, Vaccaro G, Buccheri S, Caramanno G. Impact on hospital admission of ST-elevation myocardial infarction patients during coronavirus disease 2019 pandemic in an Italian Hospital. J Cardiovasc Med (Hagerstown) 2020; 21: 722-4. doi: 10.2459/JCM.0000000000001053.
  • 5. Zitelny E, Newman N, Zhao D. STEMI during the COVID-19 Pandemic - An Evaluation of Incidence. Cardiovasc Pathol 2020; 48: 107232. doi: 10.1016/j.carpath.2020.107232.
  • 6. Garcia S, Albaghdadi MS, Meraj PM, Schmidt C, Garberich R, Jaffer FA, Dixon S, Rade JJ, Tannenbaum M, Chambers J, Huang PP, Henry TD. Reduction in ST-Segment Elevation Cardiac Catheterization Laboratory Activations in the United States During COVID-19 Pandemic. J Am Coll Cardiol 2020; 75: 2871-2. doi: 10.1016/j.jacc.2020.04.011.
  • 7. Braiteh N, Rehman WU, Alom M, Skovira V, Breiteh N, Rehman I, Yarkoni A, Kahsou H, Rehman A. Decrease in acute coronary syndrome presentations during the COVID-19 pandemic in upstate New York. Am Heart J 2020; 226: 147-51. doi: 10.1016/j.ahj.2020.05.009.
  • 8. Tan W, Parikh RV, Chester R, Harrell J, Franco V, Aksoy O, Dave R, Rafique A, Press M. Single Center Trends in Acute Coronary Syndrome Volume and Outcomes During the COVID-19 Pandemic. Cardiol Res 2020; 11: 256-9. doi: 10.14740/cr1096.
  • 9. Wilson SJ, Connolly MJ, Elghamry Z, Cosgrove C, Firoozi S, Lim P, Sharma R, Spratt JC. Effect of the COVID-19 Pandemic on ST-Segment-Elevation Myocardial Infarction Presentations and In-Hospital Outcomes. Circ Cardiovasc Interv 2020; 13: e009438. doi: 10.1161/CIRCINTERVENTIONS.120.009438.
  • 10. Abdelaziz HK, Abdelrahman A, Nabi A, Debski M, Mentias A, Choudhury T, Patel B, Saad M. Impact of COVID-19 pandemic on patients with ST-segment elevation myocardial infarction: Insights from a British cardiac center. Am Heart J 2020; 226: 45-8. doi: 10.1016/j.ahj.2020.04.022.
  • 11. Metzler B, Siostrzonek P, Binder RK, Bauer A, Reinstadler SJ. Decline of acute coronary syndrome admissions in Austria since the outbreak of COVID-19: the pandemic response causes cardiac collateral damage. Eur Heart J 2020; 41: 1852-3. doi: 10.1093/eurheartj/ehaa314.
  • 12. Huet F, Prieur C, Schurtz G, Gerbaud E, Manzo-Silberman S, Vanzetto G, Elbaz M, Tea V, Mercier G, Lattuca B, Duflos C, Roubille F. One train may hide another: Acute cardiovascular diseases could be neglected because of the COVID-19 pandemic. Arch Cardiovasc Dis 2020; 113: 303-7. doi: 10.1016/j.acvd.2020.04.002.
  • 13. Hauguel-Moreau M, Pillière R, Prati G, Beaune S, Loeb T, Lannou S, Mallet S, Mustafic H, Bégué C, Dubourg O, Mansencal N. Impact of Coronavirus Disease 2019 outbreak on acute coronary syndrome admissions: four weeks to reverse the trend. J Thromb Thrombolysis 2020: 1–2. doi: 10.1007/s11239-020-02201-9. Epub ahead of print.
  • 14. Lantelme P, Couray Targe S, Metral P, Bochaton T, Ranc S, Le Bourhis Zaimi M, Le Coanet A, Courand PY, Harbaoui B. Worrying decrease in hospital admissions for myocardial infarction during the COVID-19 pandemic. Arch Cardiovasc Dis 2020; 113: 443-7. doi: 10.1016/j.acvd.2020.06.001.
  • 15. Tam CF, Cheung KS, Lam S, Wong A, Yung A, Sze M, Lam YM, Chan C, Tsang TC, Tsui M, Tse HF, Siu CW. Impact of Coronavirus Disease 2019 (COVID-19) Outbreak on ST-Segment-Elevation Myocardial Infarction Care in Hong Kong, China. Circ Cardiovasc Qual Outcomes 2020; 13: e006631. doi: 10.1161/CIRCOUTCOMES.120.006631.
  • 16. Kessler T, Graf T, Hilgendorf I, Rizas K, Martens E, von Zur Mühlen C, Kraemer P, Meyer-Saraei R, Neumann FJ, Bode C, Laugwitz KL, Massberg S, Schunkert H, Weil J, Kastrati A, Sager HB. Hospital admissions with acute coronary syndromes during the COVID-19 pandemic in German cardiac care units. Cardiovasc Res 2020; 116: 1800-1. doi: 10.1093/cvr/cvaa192.
  • 17. Holy EW, Jakob P, Manka R, Stähli BE, Siegrist PT, Ruschitzka F, Templin C. Impact of a nationwide COVID-19 lockdown on acute coronary syndrome referrals. Cardiol J 2020. doi: 10.5603/CJ.a2020.0091. Epub ahead of print.
  • 18. Said K, El-Baghdady Y, Abdel-Ghany M. Acute coronary syndromes in developing countries during the COVID-19 pandemic. Eur Heart J 2020: ehaa507. doi: 10.1093/eurheartj/ehaa507. Epub ahead of print.

Presentation of acute coronary syndromes during covıd-19 pandemia: attitude of patients and health care professionals

Year 2020, , 473 - 478, 31.12.2020
https://doi.org/10.7197/cmj.814394

Abstract

Objective: COVID-19 pandemia resulted in substantial alterations in health care demand and delivery. The aim of this study is to investigate presentations and treatment strategies of acute coronary syndromes during COVID-19 pandemia.
Method: The patients presented with acute coronary syndrome between March 10 2020-June 1 2020 and in the same trimeframe in 2019 were analysed retrospectively. The patients in 2020 constituted the Pandemia group and the patients in 2019 were accepted to be controls. Presentation types, demographical and clinical characteristics as well as treatment strategies were compared between two groups.
Results: There was a 15.2% reduction in the number of acute coronary syndromes during the COVID-19 pandemia lockdown when compared to previous year. The number of patients presenting with STEMI was higher in Pandemia group when compared to controls (p=0.033). Less patients underwent coronary angiography and percutaneous coronary intervention in Pandemia group (p=0.012 and p=0.033, respectively). Antiagregant choice of physicians between clopidogrel and ticagrelol was similar (p=0.227). Aspartate aminotransferase and lactate dehidrogenase levels were significantly higher in Pandemia group compared to controls (p=0.030 and p=0.003, respectively). Hospitalization duration was similar between two groups while serum levels of troponin on the discharge day was significantly higher in Pandemia group (p=0.512 and p=0.001, respectively). 
Conclusions: COVID-19 pandemia resulted in a decline in the number of acute coronary syndromes and a trend towards conservative approach in patients with NSTEMI. It is contraversial whether mortality benefit driven from COVID-19 prevention is greater than the consequences these presentation and treatment alterations in heart attack patients.  

References

  • 1. Thygesen K, Alpert JS, Jaffe AS, Chaitman BR, Bax JJ, Morrow DA, White HD; Executive Group on behalf of the Joint European Society of Cardiology (ESC)/American College of Cardiology (ACC)/American Heart Association (AHA)/World Heart Federation (WHF) Task Force for the Universal Definition of Myocardial Infarction. Fourth Universal Definition of Myocardial Infarction (2018). Glob Heart 2018; 13: 305-38. doi: 10.1016/j.gheart.2018.08.004.
  • 2. Vecchio S, Fileti L, Reggi A, Moschini C, Lorenzetti S, Rubboli A. Impatto della pandemia COVID-19 sui ricoveri per sindrome coronarica acuta: revisione della letteratura ed esperienza monocentrica [Impact of the COVID-19 pandemic on admissions for acute coronary syndrome: review of the literature and single-center experience]. G Ital Cardiol (Rome) 2020; 21: 502-8. doi: 10.1714/3386.33635.
  • 3. De Rosa S, Spaccarotella C, Basso C, Calabrò MP, Curcio A, Filardi PP, Mancone M, Mercuro G, Muscoli S, Nodari S, Pedrinelli R, Sinagra G, Indolfi C; Società Italiana di Cardiologia and the CCU Academy investigators group. Reduction of hospitalizations for myocardial infarction in Italy in the COVID-19 era. Eur Heart J 2020 ; 41: 2083-8. doi: 10.1093/eurheartj/ehaa409.
  • 4. Di Liberto IA, Pilato G, Geraci S, Milazzo D, Vaccaro G, Buccheri S, Caramanno G. Impact on hospital admission of ST-elevation myocardial infarction patients during coronavirus disease 2019 pandemic in an Italian Hospital. J Cardiovasc Med (Hagerstown) 2020; 21: 722-4. doi: 10.2459/JCM.0000000000001053.
  • 5. Zitelny E, Newman N, Zhao D. STEMI during the COVID-19 Pandemic - An Evaluation of Incidence. Cardiovasc Pathol 2020; 48: 107232. doi: 10.1016/j.carpath.2020.107232.
  • 6. Garcia S, Albaghdadi MS, Meraj PM, Schmidt C, Garberich R, Jaffer FA, Dixon S, Rade JJ, Tannenbaum M, Chambers J, Huang PP, Henry TD. Reduction in ST-Segment Elevation Cardiac Catheterization Laboratory Activations in the United States During COVID-19 Pandemic. J Am Coll Cardiol 2020; 75: 2871-2. doi: 10.1016/j.jacc.2020.04.011.
  • 7. Braiteh N, Rehman WU, Alom M, Skovira V, Breiteh N, Rehman I, Yarkoni A, Kahsou H, Rehman A. Decrease in acute coronary syndrome presentations during the COVID-19 pandemic in upstate New York. Am Heart J 2020; 226: 147-51. doi: 10.1016/j.ahj.2020.05.009.
  • 8. Tan W, Parikh RV, Chester R, Harrell J, Franco V, Aksoy O, Dave R, Rafique A, Press M. Single Center Trends in Acute Coronary Syndrome Volume and Outcomes During the COVID-19 Pandemic. Cardiol Res 2020; 11: 256-9. doi: 10.14740/cr1096.
  • 9. Wilson SJ, Connolly MJ, Elghamry Z, Cosgrove C, Firoozi S, Lim P, Sharma R, Spratt JC. Effect of the COVID-19 Pandemic on ST-Segment-Elevation Myocardial Infarction Presentations and In-Hospital Outcomes. Circ Cardiovasc Interv 2020; 13: e009438. doi: 10.1161/CIRCINTERVENTIONS.120.009438.
  • 10. Abdelaziz HK, Abdelrahman A, Nabi A, Debski M, Mentias A, Choudhury T, Patel B, Saad M. Impact of COVID-19 pandemic on patients with ST-segment elevation myocardial infarction: Insights from a British cardiac center. Am Heart J 2020; 226: 45-8. doi: 10.1016/j.ahj.2020.04.022.
  • 11. Metzler B, Siostrzonek P, Binder RK, Bauer A, Reinstadler SJ. Decline of acute coronary syndrome admissions in Austria since the outbreak of COVID-19: the pandemic response causes cardiac collateral damage. Eur Heart J 2020; 41: 1852-3. doi: 10.1093/eurheartj/ehaa314.
  • 12. Huet F, Prieur C, Schurtz G, Gerbaud E, Manzo-Silberman S, Vanzetto G, Elbaz M, Tea V, Mercier G, Lattuca B, Duflos C, Roubille F. One train may hide another: Acute cardiovascular diseases could be neglected because of the COVID-19 pandemic. Arch Cardiovasc Dis 2020; 113: 303-7. doi: 10.1016/j.acvd.2020.04.002.
  • 13. Hauguel-Moreau M, Pillière R, Prati G, Beaune S, Loeb T, Lannou S, Mallet S, Mustafic H, Bégué C, Dubourg O, Mansencal N. Impact of Coronavirus Disease 2019 outbreak on acute coronary syndrome admissions: four weeks to reverse the trend. J Thromb Thrombolysis 2020: 1–2. doi: 10.1007/s11239-020-02201-9. Epub ahead of print.
  • 14. Lantelme P, Couray Targe S, Metral P, Bochaton T, Ranc S, Le Bourhis Zaimi M, Le Coanet A, Courand PY, Harbaoui B. Worrying decrease in hospital admissions for myocardial infarction during the COVID-19 pandemic. Arch Cardiovasc Dis 2020; 113: 443-7. doi: 10.1016/j.acvd.2020.06.001.
  • 15. Tam CF, Cheung KS, Lam S, Wong A, Yung A, Sze M, Lam YM, Chan C, Tsang TC, Tsui M, Tse HF, Siu CW. Impact of Coronavirus Disease 2019 (COVID-19) Outbreak on ST-Segment-Elevation Myocardial Infarction Care in Hong Kong, China. Circ Cardiovasc Qual Outcomes 2020; 13: e006631. doi: 10.1161/CIRCOUTCOMES.120.006631.
  • 16. Kessler T, Graf T, Hilgendorf I, Rizas K, Martens E, von Zur Mühlen C, Kraemer P, Meyer-Saraei R, Neumann FJ, Bode C, Laugwitz KL, Massberg S, Schunkert H, Weil J, Kastrati A, Sager HB. Hospital admissions with acute coronary syndromes during the COVID-19 pandemic in German cardiac care units. Cardiovasc Res 2020; 116: 1800-1. doi: 10.1093/cvr/cvaa192.
  • 17. Holy EW, Jakob P, Manka R, Stähli BE, Siegrist PT, Ruschitzka F, Templin C. Impact of a nationwide COVID-19 lockdown on acute coronary syndrome referrals. Cardiol J 2020. doi: 10.5603/CJ.a2020.0091. Epub ahead of print.
  • 18. Said K, El-Baghdady Y, Abdel-Ghany M. Acute coronary syndromes in developing countries during the COVID-19 pandemic. Eur Heart J 2020: ehaa507. doi: 10.1093/eurheartj/ehaa507. Epub ahead of print.
There are 18 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Medical Science Research Articles
Authors

Ahmet Karagöz 0000-0002-3548-1276

Zeki Günaydın 0000-0001-9779-7578

Asli Vural 0000-0002-6601-8778

Devrim Kurt 0000-0003-4230-3248

Fatih Özdemir 0000-0003-4318-9491

Fatih Özçubukçu 0000-0001-8096-929X

Publication Date December 31, 2020
Acceptance Date December 20, 2020
Published in Issue Year 2020

Cite

AMA Karagöz A, Günaydın Z, Vural A, Kurt D, Özdemir F, Özçubukçu F. Presentation of acute coronary syndromes during covıd-19 pandemia: attitude of patients and health care professionals. CMJ. December 2020;42(4):473-478. doi:10.7197/cmj.814394