In-Hospital Major Adverse Cardiovascular Events in Patients with STEMI during COVID-19 Pandemic

Authors

  • Arjatya Pramadita Mangkoesoebroto Departement of Cardiology and Vascular Medicine Dr. Kariadi Hospital/ Faculty of Medicine Diponegoro University Semarang, Indonesia, Indonesia
  • Yan Herry Departement of Cardiology and Vascular Medicine Dr. Kariadi Hospital/ Faculty of Medicine Diponegoro University Semarang, Indonesia, Indonesia
  • Sefri Noventi Sofia Departement of Cardiology and Vascular Medicine Dr. Kariadi Hospital/ Faculty of Medicine Diponegoro University Semarang, Indonesia, Indonesia
  • Udin Bahrudin Departement of Cardiology and Vascular Medicine Dr. Kariadi Hospital/ Faculty of Medicine Diponegoro University Semarang, Indonesia, Indonesia

DOI:

https://doi.org/10.36408/mhjcm.v10i1.852

Keywords:

ST-segment elevation myocardial infarction, COVID-19 pandemic, total ischaemic time, management, major adverse cardiac event

Abstract

BACKGROUND: The Coronavirus Disease 2019 (COVID-19) pandemic has become a global burden, changing healthcare system and affecting patients with ST segment elevation myocardial infarction (STEMI). Several countries reported a decrease in hospital admission, changing management, increase total ischemic time, and major cardiovascular events (MACE) in the pandemic era. However, there is limited data especially in Indonesia.

OBJECTIVE: To know the differences in admissions, characteristics, management and in-hospital MACE in STEMI patients between pre and pandemic era.

METHODS: Comparative observational analytical study was done on 169 patients in the pre-pandemic (12 March 2019-11 March 2020) compared to 163 patients in the pandemic era (12 March 2020-30 September 2021) with STEMI at dr. Kariadi Semarang Hospital. Assessment of monthly admission rates, total ischaemic time, reperfusion management, COVID-19 status and MACE were carried out.

RESULTS: During the COVID-19 pandemic, there was a decrease in the average admission of 14.1 to 8.6 patients per month (p<0.001), increase total ischaemic time of 8.78 (3.22-19.68) hours to 10.22 (3 .20-20.43) hours (p<0.001), decreased use of primary PCI (97.0% vs. 83.4%, p<0.001), increased fibrinolytic (1.8% vs8.6%,p=0.010) and no reperfusion (1.2%vs8.0%, p=0.007). There was a significant increase in MACE in the era of the COVID-19 pandemic (10.7%vs22.1%,p=0.008), with mortality (4.7%vs11.7%,p=0.035), stroke (1.2%vs1.8%,p=0.680), cardiogenic shock (4.1%vs11.0%, p=0.030), and acute pulmonary edema (3.6%vs10.4%,p=0.024).

CONCLUSION: There was a decrease in admissions and primary PCI procedure, increase use of fibrinolytics and without reperfusion, total ischemic time prolongation, and significant increase of in-hospital MACE in STEMI patients during the COVID-19 pandemic.

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Additional Files

Published

2023-03-31

How to Cite

1.
Mangkoesoebroto AP, Herry Y, Sofia SN, Bahrudin U. In-Hospital Major Adverse Cardiovascular Events in Patients with STEMI during COVID-19 Pandemic. Medica Hospitalia J. Clin. Med. [Internet]. 2023 Mar. 31 [cited 2024 May 3];10(1):88-97. Available from: http://medicahospitalia.rskariadi.co.id/medicahospitalia/index.php/mh/article/view/852

Issue

Vol. 10 No. 1 (2023): Med Hosp; March 2023

Section

Original Article

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Copyright (c) 2023 Arjatya Pramadita Mangkoesoebroto, Yan Herry, Sefri Noventi Sofia, Bahrudin Bahrudin

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