Abstract:
Objective To investigate whether COVID-19 epidemic affected patients with acute ST-segment elevation myocardial infarction (STEMI) of the approach to medical treatment, delay of medical treatment and severity of the disease, and whether there were changes in the treatment of such patients by medical institutions.
Methods A retrospective case study was conducted on 91 STEMI patients admitted to the Peking University Shenzhen Hospital between January 1, 2019 and March 31, 2020. 74 males and 17 females were enrolled, aged 29~89 (60.6±13.1) years . Patients were divided into no epidemic group and epidemic group according to the earliest onset time (starting dated January 1, 2020) of the COVID-19 patient in Shenzhen. Baseline data such as age, sex, history of underlying diseases (hypertension, diabetes, coronary heart disease, hyperlipidemia), and smoking history were analyzed, and the differences in clinical data, such as admission method, time from pain to door (PTD), reperfusion method, door to balloon (D2B) time, blood flow grade of thrombolysis in myocardial infarction (TIMI), proportion of multivessel disease (MVD), outcome and length of stay were compared between the two groups.
Results The age of patients in no epidemic group were (57.9±12.6) years, which were younger than those in the epidemic group [(63.3±13.0) years] (P<0.05); however, there were no statistically significant differences in gender, history of underlying diseases or smoking history (P>0.05). There were no statistical significance (P>0.05) between the two groups of patients in PTD time, D2B time, the way to hospital, hospitalization days and outcomes. The ratio of the patients choosing direct PCI in no epidemic group were 95.8%, which was higher than that in epidemic group (62.8%), and the ratio of choosing thrombolytic therapy in no epidemic group were lower than that of the epidemic group [0% vs. 11.6%] (P<0.05). There were no statistically significant differences in preoperative TIMI 0/1 ratio, postoperative TIMI level 3 ratio and MVD rate between the two groups (P>0.05).
Conclusions In the period of the COVID-19 epidemic, the average age of treatment for STEMI patients is relatively older, and the way to hospital is still mainly by themselves, with no delay in medical treatment but increased degree of disease severity. The proportion of medical institutions choosing thrombolysis for treatment of STEMI increases, while the proportion of direct PCI decreases.
Key words:
COVID-19,
Myocardial infraction,
PCI
Siqi Zhu, Zhao Fan, Ying Hao, Fushi Piao, Guoyin Jiang, Li Yi, Chun Wu, Qidi Zhou, Ying Yang, Xiaoran Fan, Weixing Zhang. Effects of COVID-19 epidemic on patients with acute myocardial infarction with ST-segment elevation in a grade-A tertiary hospital in Shenzhen[J]. Chinese Journal of Hygiene Rescue(Electronic Edition), 2020, 06(05): 257-261.