Cardiology Research, ISSN 1923-2829 print, 1923-2837 online, Open Access
Article copyright, the authors; Journal compilation copyright, Cardiol Res and Elmer Press Inc
Journal website https://www.cardiologyres.org

Original Article

Volume 11, Number 6, December 2020, pages 386-391


Delays in Presentation in Patients With Acute Myocardial Infarction During the COVID-19 Pandemic

Figures

Figure 1.
Figure 1. Time delays in patients presenting with NSTEMI. NSTEMI: non-ST-segment elevation myocardial infarction.
Figure 2.
Figure 2. Time delays in patients presenting with STEMI. STEMI: ST-segment elevation myocardial infarction.

Tables

Table 1. Characteristics and Clinical Course of Patients Presenting With Acute Myocardial Infarction During (March 2020) and Before (March 2019) the COVID-19 Pandemic
 
VariableNSTEMISTEMI
2020 (n = 30)2019 (n = 62)P value2020 (n = 47)2019 (n = 60)P value
Superscripts indicate missing data in each of the four groups. Hypertension: patients receiving antihypertensive therapy prior to admission or had to be initiated on antihypertensive therapy during hospitalization due to consistently elevated blood pressure of ≥ 140/90 mm Hg. Obesity: body mass index ≥ 30 kg/m2. NSTEMI: non-ST-segment elevation myocardial infarction; STEMI: ST-segment elevation myocardial infarction; PCI: percutaneous coronary intervention.
Male22 (73%)37 (60%)0.200534 (72%)39 (65%)0.4183
Age (years)70 (64, 80)69.5 (60, 79)0.540167 (59, 76)68.5 (59, 83)0.3179
Obesity16 (53%)25 (40%)0.239219 (40%)20 (33%)0.4493
Hypertension (0, 1, 1, 0)29 (97%)56 (92%)0.659440 (87%)54 (90%)0.6240
Smoking (1, 1, 1, 0)5 (17%)11 (18%)0.926910 (22%)15 (25%)0.6951
Diabetes mellitus (0, 1, 1, 0)10 (33%)16 (26%)0.480711 (24%)11 (18%)0.4826
Coronary artery disease15 (50%)25 (40%)0.380118 (38%)17 (28%)0.2756
Prior coronary artery bypass grafting (1, 1, 1, 0)7 (24%)2 (3.3%)0.00443 (6.5%)1 (1.7%)0.3144
Chronic obstructive pulmonary disease (0, 1, 1, 0)0 (0%)1 (1.6%)1.00001 (2.2%)2 (3.3%)1.0000
Peripheral arterial disease (1, 1, 1, 0)3 (10%)1 (1.6%)0.09650 (0%)2 (3.3%)0.5040
Cerebrovascular disease (1, 1, 1, 0)3 (10%)5 (8.2%)0.70924 (8.7%)5 (8.3%)1.0000
Pain-to-door time (min) (0, 2, 0, 1)1,855 (880, 5,732)606 (388, 944)< 0.0001620 (255, 1,500)349 (146, 659)0.0141
Door-to-reperfusion time (min) (5, 23, 4, 3)332 (182, 581)194 (92, 329)0.037176 (64, 113)86 (56, 126)0.9833
Number of diseased vessels (0, 1, 0, 0)2 (2, 3)2 (1, 3)0.18572 (1, 3)2 (1, 3)0.6462
Ejection fraction after PCI (2, 3, 2, 2)42.5 (38, 49)48 (40, 50)0.123543 (35, 50)40 (35, 45)0.4401
Reperfusion strategy0.10731.0000
    Coronary artery bypass grafting surgery2 (7%)13 (21%)2 (4%)2 (3%)
  PCI25 (83%)38 (61%)44 (94%)57 (95%)
  Non-obstructive CAD3 (10%)11 (18%)1 (2%)1 (2%)
Angiography access0.00010.8034
  Femoral10 (33%)7 (11%)7 (15%)10 (17%)
  Right radial16 (53%)55 (89%)40 (85%)50 (83%)
  Left proximal radial4 (13%)0 (0%)0 (0%)0 (0%)
Culprit vessel (5, 23, 3, 3)0.34040.0319
  Right coronary artery4 (16%)4 (10%)12 (27%)14 (25%)
  Left main2 (8%)10 (26%)1 (2.3%)12 (21%)
  Left anterior descending10 (40%)13 (33%)26 (59%)23 (40%)
  Left circumflex9 (36%)12 (31%)5 (11%)8 (14%)
Right coronary dominance26 (87%)56 (90%)0.723137 (79%)56 (93%)0.0261

 

Table 2. Outcomes of Patients Presenting With Acute Myocardial Infarction During (March 2020) and Before (March 2019) the COVID-19 Pandemic
 
OutcomeNSTEMISTEMI
2020 (n = 30)2019 (n = 62)P value2020 (n = 47)2019 (n = 60)P value
Superscripts indicate missing data in each of the four groups. STEMI: ST-segment elevation myocardial infarction; NSTEMI: non-ST-segment elevation myocardial infarction.
In-hospital hemorrhagic stroke (1, 0, 0, 1)0 (0%)0 (0%)-0 (0%)0 (0%)-
In-hospital ischemic stroke (0, 0, 0, 1)0 (0%)0 (0%)-1 (2.1%)0 (0%)0.4434
In-hospital cardiopulmonary resuscitation2 (6.7%)3 (4.8%)0.65972 (4.3%)4 (6.7%)0.6930
Hypotension requiring vasopressors4 (13%)5 (8.1%)0.46655 (10.6%)6 (10%)1.0000
Length of stay (days)6 (5, 9)5 (4, 7)0.31386 (5, 8)7 (5, 8.5)0.3222
  Inpatient death (0, 0, 1, 0)2 (6.7%)3 (4.8%)0.65972 (4.3%)4 (6.7%)0.6955