At height of pandemic, patients presenting with acute MI dropped drastically
The number of patients presenting with acute MI significantly declined during the peak of the COVID-19 pandemic, according a presentation at the virtual Society for Cardiovascular Angiography and Interventions Scientific Sessions.
According to the researchers, there was a 70% decline in the number of patients presenting with acute MI between April 2020 compared with April 2019, and patients who received care developed more severe symptoms due to delays in patients seeking emergency services.
“We observed a dramatic decrease in patients presenting with acute myocardial infarction during the COVID-19 pandemic. Of the patients that did seek medical care for MI during the pandemic, we observed a trend toward delay between symptom onset and hospital presentation, compared to during the previous year. This may have contributed to increased overall MI in these patients. Our findings indicate a need for improved public health messaging to ensure timely and appropriate cardiovascular care,” Nina Talmor, MD, internal medicine resident at NYU Langone Health, told Healio.
Researchers conducted a single-center, retrospective, observational study that compared patients with MI who underwent urgent invasive coronary angiography at NYU Langone Health in April 2020, during the peak of the pandemic, with those presenting in April 2019
According to the researchers, 13 patients with acute MI underwent invasive angiography in 2020, compared with 59 in 2019, a reduction of 78%. Due to limitations of testing in the early stages of the pandemic, few patients underwent COVID-19 testing before angiography, but two of 13 patients tested positive.
There was a greater number of patients who presented with STEMI (39% vs 20%; P = .3) and a longer median delay between symptom onset and hospital presentation (70.7 minutes vs. 34.2 minutes; P = .06) in April 2020 compared with April 2019, according to the researchers.
Multivessel coronary disease was not as common (31% vs. 73%, P = .01), but peak troponin concentrations were higher (83.92 ng/mL vs. 19.49 ng/mL; P = .01) in April 2020 compared with April 2019, according to the researchers.
There were no differences between the groups in the distribution of target vessels or the number of stents placed, Talmor said during the presentation.
In-hospital mortality rates from MI were 6.8% in the 2019 cohort and 7.7% in the 2020 cohort, she said.
“Our findings are consistent with prior reports of declines in patients presenting to the emergency room with acute MI during the pandemic. We hope our study will bring awareness to the need for timely cardiac care in future crises,” Talmor said in an interview.
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Talmor N, et al. Poster A-20. Presented at: Society for Cardiovascular Angiography and Interventions Scientific Sessions; April 28-May 1, 2021 (virtual meeting).