Acute Myocardial Infarction During the COVID-19 Pandemic: An Update on Clinical Characteristics and Outcomes

The outbreak of coronavirus disease 2019 (COVID-19) has rapidly become a worldwide pandemic. On top of respiratory complications, COVID-19 is associated with major direct and indirect cardiovascular consequences, with the latter probably being even more relevant, especially in the setting of time-dependent cardiovascular emergencies. A growing amount of data suggests a dramatic decline in hospital admissions for acute myocardial infarction (AMI) worldwide during the COVID-19 pandemic, mostly since patients did not activate emergency medical systems because hospitals were perceived as dangerous places regarding the infection risk. Moreover, during the COVID-19 pandemic, patients with AMI had a significantly higher in-hospital mortality compared to those admitted before COVID-19, potentially due to late arrival to the hospital. Finally, no consensus has been reached regarding the most adequate healthcare management pathway for AMI and shared guidance on how to handle patients with AMI during the pandemic is still needed. In this review, we will provide an update on epidemiology, clinical characteristics, and outcomes of patients with AMI during the COVID-19 pandemic, with a special focus on its collateral cardiac impact.

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Hospital Admissions for Acute Myocardial Infarction Before and After Lockdown According to Regional Prevalence of COVID-19 and Patient Profile

SSRN Electronic Journal ◽

10.2139/ssrn.3619808 ◽

2020 ◽

Author(s):

Jules Mesnier ◽

Yves Cottin ◽

Pierre Coste ◽

Emile Ferrari ◽

Francois Schiele ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Hospital Admissions ◽

Patient Profile ◽

Before And After

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Incidence, Clinical Characteristics, and Prognostic Significance of Right Bundle-Branch Block in Acute Myocardial Infarction

Circulation ◽

10.1161/01.cir.96.4.1139 ◽

1997 ◽

Vol 96 (4) ◽

pp. 1139-1144 ◽

Cited By ~ 71

Author(s):

Antonio Melgarejo-Moreno ◽

Jose Galcerá-Tomás ◽

Arcadio García-Alberola ◽

Mariano Valdés-Chavarri ◽

Francisco J. Castillo-Soria ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Right Bundle Branch Block ◽

Clinical Characteristics ◽

Prognostic Significance ◽

Bundle Branch Block

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Daylight saving time does not seem to be associated with number of percutaneous coronary interventions for acute myocardial infarction in the Netherlands

Netherlands Heart Journal ◽

10.1007/s12471-021-01566-7 ◽

2021 ◽

Author(s):

L. Derks ◽

◽

S. Houterman ◽

G. S. C. Geuzebroek ◽

P. van der Harst ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

The Netherlands ◽

Incidence Rate ◽

Hospital Admissions ◽

Control Period ◽

Daylight Saving Time ◽

Daylight Saving ◽

Percutaneous Coronary ◽

Acute Mi

Abstract Background In multiple studies, the potential relationship between daylight saving time (DST) and the occurrence of acute myocardial infarction (MI) has been investigated, with mixed results. Using the Dutch Percutaneous Coronary Intervention (PCI) registry facilitated by the Netherlands Heart Registration, we investigated whether the transitions to and from DST interact with the incidence rate of PCI for acute MI. Methods We assessed changes in hospital admissions for patients with ST-elevation myocardial infarction (STEMI) or non-STEMI (NSTEMI) undergoing PCI between 1 January 2015 and 31 December 2018. We compared the incidence rate of PCI procedures during the first 3 or 7 days after the transition with that during a control period (2 weeks before transition plus second week after transition). Incidence rate ratio (IRR) was calculated using Poisson regression. Potential gender differences were also investigated. Results A total of 80,970 PCI procedures for STEMI or NSTEMI were performed. No difference in incidence rate a week after the transition to DST in spring was observed for STEMI (IRR 0.95, 95% confidence interval (CI) 0.87–1.03) or NSTEMI (IRR 1.04, 95% CI 0.96–1.12). After the transition from DST in autumn, the IRR was also comparable with the control period (STEMI: 1.03, 95% CI 0.95–1.12, and NSTEMI: 0.98, 95% CI 0.91–1.06). Observing the first 3 days after each transition yielded similar results. Gender-specific results were comparable. Conclusion Based on data from a large, nationwide registry, there was no correlation between the transition to or from DST and a change in the incidence rate of PCI for acute MI.

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P5502Comparison of clinical characteristics and prognosis between non-octogenarians and octogenarians with cardiac troponin positive acute myocardial infarction

European Heart Journal ◽

10.1093/eurheartj/ehz746.0452 ◽

2019 ◽

Vol 40 (Supplement_1) ◽

Author(s):

T Soeda ◽

M Ishihara ◽

F Fujino ◽

H Ogawa ◽

K Nakao ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Hospital Mortality ◽

Cardiac Troponin ◽

Clinical Characteristics ◽

St Segment Elevation ◽

The Poor ◽

St Segment ◽

Universal Definition ◽

Multicenter Registry

Abstract Background Cardiac troponin (cTn) is the preferred biomarker for the diagnosis of acute myocardial infarction (AMI). Octogenarians who presented cTn positive AMI are not usually recruited in clinical trials. Therefore, their clinical characteristics and prognosis are rarely investigated. Objective To study the characteristics and prognosis in octogenarians who presented cTn positive AMI. Methods and results The Japanese registry of acute Myocardial INfarction diagnosed by Universal dEfiniTion (J-MINUET) is a prospective and multicenter registry. A total of 3,283 consecutive AMI patients who were diagnosed by cTn-based criteria were included. The patients were divided into non-octogenarians (n=2,593) and octogenarians (n=690). Compared with non- octogenarians, octogenarians showed significantly lower incidence of diabetes mellitus (37.6% and 31.9%, p=0.006) and dyslipidemia (53.6% and 45.6%, p<0.001), and significantly higher incidence of hypertension (64.1% and 75.3%, p<0.001) and chronic kidney disease (38.7% and 68.7%, p<0.001). Octogenarians showed significantly longer onset to door time (p<0.001) and longer door to device time (p<0.001). Though, compared with non-octogenarians, octogenarians showed lower peak CK (2,506 and 1,926, p<0.001), LVEF was significantly lower in octogenarians (54.6% and 52.6%, p=0.005). The presentation of AMI was different between the two group. The incidence of ST-segment elevation MI (STEMI) was 70.7% in non-octogenarians and 62.0% in octogenarians. Non-STEMI with CK elevation and without CK elevation were 16.2% and 13.1% in non- octogenarians, and 20.9% and 17.1% in octogenarians. In-hospital mortality was higher in octogenarians (4.7% and 13.2%, P<0.001). Especially, octogenarians with STEMI and non-STEMI with CK elevation showed the highest in-hospital mortality. And octogenarians without CK elevation showed similar in hospital mortality with non-octogenarians with STEMI (Figure). Conclusions J-MINUET showed the poor prognosis of octogenarians who were diagnosed as AMI based on cTn. Acknowledgement/Funding None

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