Figure 1. Kaplan-Meier time to event model for 30-day mortality in patients with STEMI in 2019 - 2020. STEMI: ST-segment elevation myocardial infarction.
| 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 13, Number 1, February 2022, pages 50-56
Clinical Characteristics, Management, and Outcomes of the Patients With ST-Segment Elevation Myocardial Infarction Before and During the COVID-19 Pandemic
Figure
Tables
| During COVID-19 pandemic (n = 234, 46.8%) | Before pandemic (n = 266, 53.2%) | P value | |
|---|---|---|---|
| COVID-19: coronavirus disease 2019; STEMI: ST-segment elevation myocardial infarction; UAE: United Arab Emirates; SD: standard deviation; CVD: cardiovascular disease; EMS: emergency medical service; ED: emergency department; ACEI: angiotensin-converting enzyme inhibitor; ARBs: angiotensin-receptor blockers; ECG: electrocardiogram. | |||
| Demography | |||
| Age, years, mean ± SD | 50.39 ± 10.32 | 51.36 ± 9.93 | 0.228 |
| Female, n (%) | 15 (6.4) | 21 (7.9) | 0.604 |
| UAE national | 14 (6) | 31 (11.7) | 0.027 |
| COVID-19 positive | 11 (4.7) | - | - |
| Risk factors | |||
| Hypercholesterolemia | 119 (50.9) | 79 (29.7) | < 0.001 |
| Diabetes | 75 (32.1) | 86 (32.3) | 0.946 |
| Current smoking | 70 (22.9) | 69 (25.9) | 0.322 |
| Hypertension | 33 (14.1) | 58 (21.8) | 0.025 |
| Family history of CVD | 80 (34.2) | 98 (36.8) | 0.536 |
| Coronary artery disease | 44 (18.8) | 21 (7.9) | < 0.001 |
| Medications before | 0.721 | ||
| Antiplatelet | 7 (4.7) | 7 (4.2) | |
| Anticoagulant | 7 (4.7) | - | |
| Statin | 52 (34.9) | 55 (33.3) | |
| ACEI/ARBs | 59 (39.6) | 75 (45.5) | |
| Appropriate recommended therapy | 31 (20.8) | 28 (17) | |
| Presentation | |||
| Arrival mode: EMS | 111 (47.4) | 149 (56) | 0.138 |
| Location of code: ED | 93 (39.7) | 164 (61.7) | < 0.001 |
| Transfer | 46 (19.7) | 56 (21.1) | 0.296 |
| Symptoms | |||
| Chest pain | 226 (96.6) | 250 (94.7) | 0.175 |
| Shortness of breath | 8 (3.4) | 4 (1.5) | 0.162 |
| At admission | |||
| Temperature, mean ± SD, (°C) | 38.3 ± 22.8 | 36.6 ± 3.27 | 0.053 |
| Heart rate, mean ± SD, beats/min | 86.35 ± 61.98 | 82.80 ± 17.62 | 0.028 |
| SBP, mean ± SD, mm Hg | 133.37 ± 25.74 | 135.48 ± 25.53 | 0.266 |
| DBP, mean ± SD, mm Hg | 82.65 ± 18.03 | 91.32 ± 11.78 | 0.640 |
| Respiratory rate, mean ± SD, breaths/min | 21.21 ± 8.01 | 19.90 ± 3.98 | 0.017 |
| Clinical features | |||
| Arrhythmias | 36 (15.4) | 23 (8.6) | 0.015 |
| Atrial fibrillation | 9 (3.8) | 8 (3) | |
| Ventricular fibrillation | 18 (7.6) | 7 (2.7) | |
| Other types | 9 (3.8) | 8 (3) | |
| Left ventricular ejection fraction (%) | 0.232 | ||
| ≤ 35 | 51 (21.8) | 61 (22.9) | |
| ≤ 50 | 117 (50) | 112 (42.1) | |
| > 50 | 55 (23.5) | 82 (30.8) | |
| D-dimer (µg/mL) | 0.67 ± 0.69 | 0.69 ± 0.53 | |
| Troponin (ng/mL) | 0.40 ± 1.26 | 1.46 ± 8.38 | |
| Creatinine (mg/dL) | 1.03 ± 0.72 | 1.03 ± 0.64 | 0.064 |
| ECG confirmed STEMI | 220 (96.5%) | 256 (98.1%) | 0.399 |
| Location of infraction | 0.014 | ||
| Anterior wall | 98 (41.9) | 133 (50.2) | |
| Inferior wall | 127 (54.3) | 112 (42.3) | |
| Posterior wall | 7 (3) | 7 (2.6) | |
| Lateral | 2 (0.9) | 12 (4.5) | |
| During COVID-19 pandemic (n = 234, 46.8%) | Before pandemic (n = 266, 53.2%) | P value | |
|---|---|---|---|
| COVID-19: coronavirus disease 2019; SD: standard deviation; PCI: percutaneous coronary intervention; D1: first diagonal; OM: obtuse marginal. | |||
| Time to balloon, mean ± SD, min | 56.6 ± 27.26 | 64.58 ± 19.5 | < 0.001 |
| Intra-aortic balloon pump | 14 (6) | 15 (5.6) | |
| Culprit artery | 0.244 | ||
| Left anterior descending | 103 (44) | 133 (50) | |
| Right coronary artery | 89 (38) | 84 (31.6) | |
| Left circumflex artery | 34 (14.5) | 36 (13.5) | |
| D1 | 2 (0.9) | 3 (1.1) | |
| OM | 10 (3.8) | 3 (1.3) | |
| Number of diseased vessels | 0.951 | ||
| Single | 228 (97.4) | 257 (96.6) | |
| Two | 6 (2.6) | 7 (2.6) | |
| Number of stentings | < 0.001 | ||
| Single | 212 (44.1) | 200 (41.6) | |
| Two | 10 (2.1) | 51 (10.6) | |
| Three | - | 8 (1.7) | |
| Performed staged PCI | 28 (5.6) | 70 (14) | < 0.001 |
| Length of hospitalization, mean ± SD, days | 4.7 ± 6.8 | 5.4 ± 9.4 | < 0.001 |
| Outcomes | |||
| Discharged | 212 (90.6) | 245 (92.1) | 0.192 |
| Referred to long-term care | 17 (7.3) | 11 (4.1) | |
| Re-infarction | 2 (0.9) | 4 (1.5) | 0.022 |
| Death | 5 (2.1) | 8 (3) | 0.217 |