Abstract

Background

In this study, we aimed to compare the management and clinical outcomes of patients with acute coronary syndrome (ACS) before and during pandemic.

Methods

A total of 239 patients with ACS were enrolled into the study. Patients who were admitted during pandemic were compared with pre-pandemic patients according to their demographic, biochemical, angiographic features, revascularisation strategies and clinical outcomes.

Results

During the pandemic period, we observed an increase in total number of patient with ST elevation myocardial infarction patients compared to the pre-pandemic period. Initial high sensitive troponin and CK-MB levels were statistically higher in the pandemic group patients (1953 pg/ml versus 259 pg/ml for troponin I and 14 ng/ml versus 6 ng/ml for CK-MB p < 0.0001, p = 0.02, respectively). Type 4a myocardial infarction due to stent thrombosis was more frequent in pandemic group relative to the pre-pandemic group (10 versus 0, p = 0.003). Post-procedural TIMI flow grade was lower in the pandemic group and distal embolisation and TIMI thrombus score were significantly higher in the pandemic group compared to the pre-pandemic group (p = 0.001, p = 0.02, and p = 0.002, respectively). The number of patients who underwent bypass surgery was much lower compared to pre-pandemic period (27 versus 8, p < 0.0001). There was no statistically significant difference in hospital mortality and short-term all-cause mortality among groups (p > 0.05).

Conclusion

Although clinical, laboratory, and angiographic features were worse in ACS patients during pandemic, the mortality rate of ACS was similar in both pre-pandemic and pandemic era. It is important to keep coronary intensive care units and catheter labs open and fully-functioning during the pandemic.

中文翻译：

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COVID-19 大流行时代急性冠状动脉综合征患者的血运重建策略和结果是否不同：三级中心的经验

摘要

背景

在这项研究中，我们旨在比较大流行之前和期间急性冠状动脉综合征 (ACS) 患者的管理和临床结果。

方法

共有 239 名 ACS 患者被纳入研究。根据人口统计学、生化、血管造影特征、血运重建策略和临床结果，将大流行期间入院的患者与大流行前患者进行了比较。

结果

在大流行期间，我们观察到与大流行前相比，ST 段抬高型心肌梗死患者总数有所增加。大流行组患者的初始高敏肌钙蛋白和 CK-MB 水平在统计学上更高（肌钙蛋白 I 为 1953 pg/ml 对 259 pg/ml，CK-MB 为 14 ng/ml 对 6 ng/ml p  < 0.0001，p  = 0.02，分别）。与大流行前组相比，大流行组因支架内血栓形成的 4a 型心肌梗死更为常见（10 比 0，p  = 0.003）。与大流行前组相比，大流行组术后 TIMI 血流分级较低，大流行组远端栓塞和 TIMI 血栓评分显着更高（p = 0.001、p  = 0.02 和p  = 0.002）。与大流行前相比，接受搭桥手术的患者人数要少得多（27 对 8，p  < 0.0001）。各组住院死亡率、短期全因死亡率差异无统计学意义（P  > 0.05）。

结论

尽管大流行期间 ACS 患者的临床、实验室和血管造影特征较差，但 ACS 的死亡率在大流行前和大流行时期相似。在大流行期间保持冠状动脉重症监护病房和导管实验室开放和全面运作非常重要。