A Comparison between Pre-outbreak and Outbreak of Coronavirus Disease (COVID-19) in Patients with ST-segment Elevation Myocardial Infarction: A Thailand Single-center Study
Supamongkol Phoopattana1, Songsak Kiatchoosakun1, Burabha Pussadhamma1, Chaiyasith Wongvipaporn1
Affiliation : 1 Srinagarind Hospital and Queen Sirikit Heart Center of the Northeast, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
Background: Coronavirus disease 2019 (COVID-19) pandemic hit the world hard in 2020. Strict heath care measures were enforced and created obstacles for ST-segment elevation myocardial infarction (STEMI) management.
Objective: To study an effect of an outbreak of COVID-19 on STEMI care and outcomes. Materials and Methods: Consecutive STEMI patients from Khon Kaen University Cardiac Catheterization Registry (KKUCCR) and Acute Coronary Syndrome (ACS) registry were used as pre-outbreak (May 2018 to July 2019) and outbreak (April 2020 to June 2020) patients, respectively. Comparison of patients’ characteristics, management, and outcomes of STEMI were conducted.
Results: 612 and 118 patients were enrolled into pre-outbreak and outbreak period, respectively. Between pre-outbreak and outbreak period, average number of patients per month was similar (40.8 vs. 39.3, p=0.76), while time from chest pain onset to first medical contact (FMC), time from FMC to wire crossing in primary percutaneous coronary intervention (PCI), and time from PCI center arrival to catheterization laboratory were significantly delayed during outbreak period (167.6±211.3 vs. 272.6±447.8 min, p=0.001, 427.9±283.3 vs. 528.8±535.4 min, p=0.04, and 90.3±141.0 vs. 159.4±419.9 min, p=0.002, respectively). A trend of increase in-hospital mortality was observed during outbreak period (5.7% vs. 10.2%, p=0.07), whereas a significant increase in all-cause death and cardiovascular death at 1 year were demonstrated in STEMI patients presented during an outbreak (8.8% vs. 22.0%, p<0.001, and 6.5% vs. 12.7%, p=0.02, respectively).
Conclusion: During early wave of COVID-19 outbreak, incidence of STEMI was not changed, however, patients’ delay and system’s delay were obvious, and mortality of STEMI patients was increased.
Received 13 March 2024| Revised 4 June 2024 | Accepted 11 June 2024
DOI: 10.35755/jmedassocthai.2024.S01.S100-S108
Keywords : COVID-19; ST-segment elevation myocardial infarction; Mortality
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