One-year outcomes of patients with ST-segment elevation myocardial infarction during the COVID-19 pandemic

• Published in: Journal of thrombosis and thrombolysis Vol. 53; no. 2; pp. 335 - 345
• Main Authors: Phua, Kailun, Chew, Nicholas W. S., Sim, Vincent, Zhang, Audrey A., Rastogi, Saurabh, Kojodjojo, Pipin, Chor, Wei-Ping Daniel, Koh, Brandon Chi-Ping, Leong, Benjamin Sieu-Hon, Ng, Zhe-Yan, Tung, Benjamin Wei-Liang, Ambhore, Anand, Kong, William K. F., Poh, Kian-Keong, Chai, Ping, Ng, Gavin, Chan, Koo-Hui, Lee, Chi-Hang, Loh, Joshua Ping-Yun, Low, Adrian Fatt-Hoe, Chan, Mark Yan-Yee, Yeo, Tiong-Cheng, Tan, Huay-Cheem, Loh, Poay-Huan
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.02.2022; Springer Nature B.V
• Subjects: Cardiology; COVID-19; Heart; Heart attacks; Hematology; Humans; Medicine; Medicine & Public Health; Mortality; Myocardial infarction; Pandemics; Patient Readmission - statistics & numerical data; Patients; Percutaneous Coronary Intervention; Recurrence; Singapore - epidemiology; ST Elevation Myocardial Infarction - epidemiology; ST Elevation Myocardial Infarction - surgery; Tertiary Care Centers; Treatment Outcome; Singapore; COVID-19; Primary percutaneous coronary intervention; ST-elevation myocardial infarction
• ISSN: 0929-5305; 1573-742X; 1573-742X
• DOI: 10.1007/s11239-021-02557-6

The pandemic has led to adverse short-term outcomes for patients with ST-segment elevation myocardial infarction (STEMI). It is unknown if this translates to poorer long-term outcomes. In Singapore, the escalation of the outbreak response on February 7, 2020 demanded adaptation of STEMI care to stringent infection control measures. A total of 321 patients presenting with STEMI and undergoing primary percutaneous coronary intervention at a tertiary hospital were enrolled and followed up over 1-year. They were allocated into three groups based on admission date—(1) Before outbreak response (BOR): December 1, 2019–February 6, 2020, (2) During outbreak response (DOR): February 7–March 31, 2020, and (3) control group: November 1–December 31, 2018. The incidence of cardiac-related mortality, cardiac-related readmissions, and recurrent coronary events were examined. Although in-hospital outcomes were worse in BOR and DOR groups compared to the control group, there were no differences in the 1-year cardiac-related mortality (BOR 8.7%, DOR 7.1%, control 4.8%, p = 0.563), cardiac-related readmissions (BOR 15.1%, DOR 11.6%, control 12.0%, p = 0.693), and recurrent coronary events (BOR 3.2%, DOR 1.8%, control 1.2%, p = 0.596). There were higher rates of additional PCI during the index admission in DOR, compared to BOR and control groups (p = 0.027). While patients admitted for STEMI during the pandemic may have poorer in-hospital outcomes, their long-term outcomes remain comparable to the pre-pandemic era.