Öz
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.