The Coronavirus disease 2019 (COVID-19) pandemic has changed the way patients seek medical attention and how medical services are provided. We sought to compare characteristics, clinical course, and outcomes of patients presenting with acute myocardial infarction (AMI) during the pandemic compared to before it. This is a multicenter, retrospective cohort study of consecutive COVID-19 negative patients with AMI in Lithuania from March 11, 2020 to April 20, 2020 compared to patients admitted with the same diagnosis during the same period in 2019. All patients underwent angiography. Six-month follow-up was obtained for all patients. A total of 269 patients were included in this study, 107 (40.8%) of whom presented during the pandemic. Median pain-to-door times were significantly longer (858 [quartile 1=360, quartile 3 = 2600] vs. 385.5 [200, 745] mins, p<0.0001) and post-revascularization ejection fractions were significantly lower (35 [30, 45] vs. 45 [40, 50], p<0.0001) for patients presenting during vs. prior to the pandemic. While the in-hospital mortality rate did not differ, we observed a higher rate of six-month major adverse cardiovascular events (MACE) for patients who presented during vs. prior to the pandemic (30.8% vs 13.6%, p = 0.0006). In conclusion, 34% fewer patients with AMI presented to the hospital during the COVID-19 pandemic, and those who did waited longer to present and experienced more 6-month MACE compared to patients admitted before the pandemic.
Ali Aldujeli, Anas Hamadeh, Kristen M Tecson, Zilvinas Krivickas, Laurynas Maciulevicius, Simas Stiklioraitis, Marius Sukys, Kasparas Briedis, Montazar Aldujeili, Kamilija Briede, Rima Braukyliene, Andrius Pranculis, Ramunas Unikas, Diana Zaliaduonyte, Peter A McCullough