scholarly journals Admissions and In-hospital Outcomes of Acute Coronary Syndromes during Corona Virus Disease 19 Pandemic in Albania

2021 ◽  
Vol 9 (B) ◽  
pp. 593-599
Author(s):  
Leonard Simoni ◽  
Ilir Alimehmeti ◽  
Astrit Ceka ◽  
Ermir Tafaj ◽  
Mirald Gina ◽  
...  
Keyword(s):  
Acute Coronary Syndromes ◽  
Virus Disease ◽  
Control Period ◽  
Fold Increase ◽  
University Hospital ◽  
Distance Measures ◽  
Invasive Procedures ◽  
Coronary Syndromes ◽  
St Elevation ◽  
The Impact

   BACKGROUND: Cardiologists and surveys from all over the world have reported an important drop in admissions of patients with acute coronary syndromes (ACS) and related coronary procedures during the outbreak of coronavirus disease 19 (COVID 19) pandemic. AIM: We investigated the impact of the COVID 19 pandemic on hospitalizations for ACS and related invasive procedures in a country with low COVID 19 incidence. METHODS: We conducted a single-center, observational retrospective study including all consecutive patients admitted for ACS in the Cardiology Department of University Hospital Center Mother Theresa from March 9, 2020 (1st day of application of social distance measures) to April 30th (period of total lockdown). Patients admitted in the same time period in 2019 served as controls. All data were collected from the medical files. Admissions were classified as ST-elevation myocardial infarction (STEMI) or non-ST-elevation ACS (NSTEACS). Total and weekly admissions and invasive procedures were assessed. Mean incidence difference (MID) in weekly ACS admissions and procedures was also calculated. RESULTS: Overall, 781 patients were included in this analysis: 321 patients (37%) were admitted during study period and 550 patients (63%) were admitted during the control period (overall reduction of 41.6%; weekly MID of 28.6 (95% confidence interval [CI] 13.3 to 44.0; p = 0.001). The occurrence of all ACS types was reduced: STEMI, by 28.1%; weekly MID 7.3 [0.6-15.2]; p = 0.048]; NSTEACS by 50.5%, weekly MID 19.1 [13.9-24.4]; p < 0.001]. Invasive procedures were also reduced: coronary angiography by 42.5%, weekly MID 26.6 [13.4-39.2]; p = 0.001]; percutaneous coronary intervention (PCI) by 42.3%, weekly MID 16.1 [5.9-26.3], p = 0.004]. Compared to 2019, during the COVID-19 period, there was a 2.4 fold increase in the inhospital death (3% vs 7.2%) with a significant weekly MID 1.4 [0.2-2.7) P=0.032]. A 2.6-fold increase in the occurrence of cardiogenic shock was also observed (13.1% vs. 5.1%, p < 0.0001). CONCLUSIONS: The admissions for ACS and invasive revascularization procedures were significantly reduced, whereas the death rate was increased during COVID 19 pandemic outbreak in Albania compared with the same period in 2019.

scholarly journals Unpredictable Fall of Severe Emergent Cardiovascular Diseases Hospital Admissions During the COVID‐19 Pandemic: Experience of a Single Large Center in Northern Italy

2020 ◽  
Vol 9 (13) ◽  
Author(s):  
Mauro Toniolo ◽  
Francesco Negri ◽  
Marco Antonutti ◽  
Marco Masè ◽  
Domenico Facchin
Keyword(s):  
Cardiovascular Diseases ◽  
Acute Coronary Syndromes ◽  
Hospital Admissions ◽  
Early Recognition ◽  
Time Frame ◽  
Northern Italy ◽  
University Hospital ◽  
Tertiary Referral Center ◽  
Coronary Syndromes ◽  
The Impact

Background Northern Italy is one of the epicenters of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV 2) pandemic in Europe. The impact of the pandemic and the consequent lockdown on medical emergencies other than those SARS‐CoV 2 pandemic related is largely unknown. The aim of this study was to analyze the epidemiologic impact of coronavirus disease 2019 pandemic on hospital admission for severe emergent cardiovascular diseases ( SECD s) in a single Northern Italy large tertiary referral center. Methods and Results We quantified SECD s admissions to the Cardiology Division of Udine University Hospital between March 1, 2020 and March 31, 2020 and compared them with those of the same time frame during 2019. Compared with March 2019, we observed a significant reduction in all SECD s admissions: −30% for ST ‐segment–elevation acute coronary syndromes, −66% for non‐ ST ‐segment–elevation acute coronary syndromes and −50% for severe bradyarrhythmia. Conclusions A significant decrease in all SECD s admissions has been observed during the SARS‐CoV 2. pandemic and was unlikely caused by a reduction in the incidence of cardiovascular diseases. Fear of contagion may have contributed to the unpredictable drop of SECD s. Social education about early recognition of symptoms of life‐threatening cardiac conditions requiring appropriate care in a timely fashion may help to reduce this counterproductive phenomenon.

scholarly journals 342 Impact of temporary traffic bans on the risk of acute coronary syndromes in a large metropolitan area

2020 ◽  
Vol 22 (Supplement_N) ◽  
pp. N81-N82
Author(s):  
Alessandra De Luca ◽  
Igino Proietti ◽  
Carlo Trani ◽  
Andrea Berni ◽  
Sonia Cristina Sergi ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Myocardial Infarction ◽  
Metropolitan Area ◽  
Acute Coronary Syndromes ◽  
Coronary Intervention ◽  
St Elevation Myocardial Infarction ◽  
Large Metropolitan Area ◽  
Coronary Syndromes ◽  
St Elevation ◽  
The Impact

Abstract Aims Strong epidemiologic evidence has highlighted the role of pollution, on top of adverse climate features, as a novel cardiovascular risk factor. However, mechanistic proof that reducing pollution may be beneficial to prevent atherothrombotic events is limited. We aimed at appraising the impact of temporary traffic bans in a large metropolitan area on the risk of acute coronary syndromes. Methods and results Aggregate and anonymized data from 15 tertiary cardiac care centers were obtained detailing pre-coronarivus disease 2019 (COVID-19) daily cases of ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI), including those treated with percutaneous coronary intervention (PCI). Data on pollutants and climate were sought for the same days. Mixed level regression was used to compare the week before vs. after the traffic ban (Fortnight analysis), the 3 days before vs. after (Weekly analysis) and the Sunday before vs. after (Sunday analysis). A total of 8 days of temporary traffic bans were included, occurring between 2017 and 2020, totaling 802 STEMI and 1196 NSTEMI in the Fortnight analysis, 382 STEMI and 585 in the Weekly analysis, and 148 STEMI and 210 NSTEMI in the Sunday analysis. Fortnight and Sunday analysis did not disclose a significant impact of traffic ban on STEMI or NSTEMI (all P &gt; 0.05). Conversely, Weekly analysis showed non-significant changes for STEMI but a significant decrease in daily NSTEMI when comparing the 3 days before the traffic ban with the ban day (P = 0.043), as well as the 3 days before vs. the 3 days after the ban (P = 0.025). No statistically significant effect of traffic ban was found at Fortnight, Weekly or Sunday analyses for daily mean concentrations of benzene, carbon monoxide, nitric oxide, nitrogen dioxide, ozone, sulfur dioxide, particulate matter (PM) &lt;2.5 µm or PM &lt; 10 µm (all P &gt; 0.05). However, minimum daily concentrations showed a significant reduction of ozone during the ban in comparison to the week preceding it (P = 0.034), nitric oxide during the ban in comparison to the 3 days preceding it (P = 0.046), and an increase in benzene during the ban in comparison to the Sunday before (P = 0.039). Conclusion Temporary traffic bans may favorably reduce coronary atherothrombotic events, and in particular NSTEMI, even if not globally and immediately impacting on environmental pollution. Further controlled studies are required to confirm and expand this hypothesis-generating results.

Special conditions: acute coronary syndromes

ESC CardioMed ◽  
2018 ◽  
pp. 929-935
Author(s):  
Baris Gencer ◽  
Marco Roffi
Keyword(s):  
Coronary Angiography ◽  
Acute Coronary Syndromes ◽  
Positive Impact ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
Patients With Diabetes ◽  
Coronary Syndromes ◽  
St Elevation ◽  
Intensive Glucose Lowering ◽  
The Impact

Diabetes is a major risk factor for cardiovascular disease and is associated with an increased risk of mortality in the setting of acute coronary syndromes. Like patients without diabetes, ST elevation and non-ST elevation myocardial infarction patients mandate immediate and within 24 h coronary angiography, respectively. Even in the absence of troponin elevation, all patients with diabetes with suspected acute coronary syndromes should undergo coronary angiography within 72 h due to their increased risk (which is not the case for individuals without diabetes). Antiplatelet treatment should be handled as in patients without diabetes, and the more potent P2Y12 inhibitors prasugrel and ticagrelor should be preferred over clopidogrel. Overall, trials investigating the impact of intensive glucose-lowering therapies in the acute phase of acute coronary syndromes did not show a positive impact on clinical outcomes. In the long term, efforts in secondary prevention to reach recommended global preventive targets are especially important in this patient population to improve survival and reduce the recurrence of ischaemic events.

The impact of tobacco cessation on the evolution of patients with non-ST-elevation acute coronary syndromes.

2018 ◽  
Author(s):  
Nouha Ayedi ◽  
Rim Khemakhem ◽  
Nessrine Kammoun ◽  
Walid Feki ◽  
Najla Bahloul ◽  
...  
Keyword(s):  
Acute Coronary Syndromes ◽  
Tobacco Cessation ◽  
Coronary Syndromes ◽  
St Elevation ◽  
The Impact

scholarly journals REGIONAL CARDIAC NETWORK: THE EXPERIENCE AT THE EMERGENCY MEDICAL SERVICE 118 IN THE BASILICATA REGION IN ITALY

2015 ◽  
Vol 3 (5) ◽  
pp. 95-110
Author(s):  
Antonietta Zaccaro ◽  
Antonio Bonacaro
Keyword(s):  
Myocardial Infarction ◽  
Emergency Medical Service ◽  
Acute Coronary Syndromes ◽  
Medical Service ◽  
Clinical Practices ◽  
Basilicata Region ◽  
Emergency Medical ◽  
Coronary Syndromes ◽  
St Elevation ◽  
The Impact

The aim of the regional cardiac networks is to offer to those patients affected by Acute Myocardial Infarction (AMI) the quickest and the most efficient treatment in relation to patients' characteristics and to the place where the event occurs. This article describes the experience developed by the Regional Emergency Medical Service of the Basilicata Region (Italy) in creating such a network. The structure of the network, the epidemiological data along with the different types of pathway used in the management of Non-ST elevation acute coronary syndromes are delineated with the aim to offer an overview of the clinical practices actually in place. A retrospective observational study was conducted in 2012 with the aim to understand the incidence of AMI in its various forms: ST segment elevation myocardial infarction (STEMI) and Non-ST elevation acute coronary syndromes (NSTEACS). The development of the Regional Cardiac Network has been shedding light on AMI and giving patients the chance to receive a customized treatment according to their clinical conditions. Further studies are recommended in order to understand the impact of these practices in terms of reduction of mortality and complications.

scholarly journals 339 Interplay between COVID-19, pollution, and weather features on changes in the incidence of acute coronary syndromes in early 2020

2020 ◽  
Vol 22 (Supplement_N) ◽  
pp. N17-N18
Author(s):  
Simone Griffo ◽  
Achille Gaspardone ◽  
Alessandro Danesi ◽  
Fabio Ferranti ◽  
Enrica Mariano ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Metropolitan Area ◽  
Acute Coronary Syndromes ◽  
Tertiary Care ◽  
St Elevation Myocardial Infarction ◽  
Lazio Region ◽  
Multi Stage ◽  
Coronary Syndromes ◽  
St Elevation ◽  
The Impact

Abstract Aims Coronavirus disease 2019 (COVID-19) has caused an unprecedented change in the apparent epidemiology of acute coronary syndromes (ACS). However, the interplay between this disease, changes in pollution, climate, and aversion to activation of emergency medical services represents a challenging conundrum. We aimed at appraising the impact of COVID-19, weather, and environment features on the occurrence of ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI) in a large Italian region and metropolitan area. Methods and results Italy was hit early on by COVID-19, such that state of emergency was declared on January 31, 2020, and national lockdown implemented on March 9, 2020, mainly because the accrual of cases in Northern Italy. In order to appraise the independent contribution on changes in STEMI and NSTEMI daily rates of COVID-19, climate and pollution, we collected data on these clinical events from tertiary care cardiovascular centers in the Lazio region and Rome metropolitan area. Multilevel Poisson modeling was used to appraise unadjusted and adjusted effect estimates for the daily incidence of STEMI and NSTEMI. The sample included 1448 STEMI and 2040 NSTEMI, with a total of 2882 PCI spanning 6 months. Significant reductions in STEMI and NSTEMI were evident already in early February 2020 (all P &lt; 0.05), concomitantly with COVID-19 spread and institution of national countermeasures. Changes in STEMI and NSTEMI were inversely associated with daily COVID-19 tests, cases, and/or death (P &lt; 0.05). In addition, STEMI and NSTEMI incidences were associated with daily NO2, PM10, and O3 concentrations, as well as temperature (P &lt; 0.05). Multi-stage and multiply adjusted models highlighted that reductions in STEMI were significantly associated with COVID-19 data (P &lt; 0.001), whereas changes in NSTEMI were significantly associated with both NO2 and COVID-19 data (both P &lt; 0.001). Conclusion Reductions in STEMI and NSTEMI in the COVID-19 pandemic may depend on different concomitant epidemiologic and pathophysiologic mechanisms. In particular, recent changes in STEMI may depend on COVID-19 scare, leading to excess all-cause mortality, or effective reduced incidence, whereas reductions in NSTEMI may also be due to beneficial reductions in NO2 emissions in the lockdown phase.

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