Changing pattern of admissions for acute myocardial infarction in India during the COVID-19 pandemic
| Autor: | Tom Devasia, Katyal Virender Kumar, Mrinal Kanti Das, Sreekanth Yerram, Narendranath Khanna, Nitish Naik, Geevar Zachariah, Swaminathan Nagarajan, Amal Kumar Khan, Neil Bardoloi, Pushkraj Gadkari, Gurpreet Singh Wander, Debabrata Roy, Kewal C. Goswami, Anshul Gupta, Bishav Mohan, Lekha Pathak, Cibu Mathew, Nitin Modi, Dipak Ranjan Das, Krishna Kishore Goyal, Bivin Wilson, Satyanarayan Routray, Venugopal Krishnan Nair, Shashi Bhushan Gupta, Chakkalakkal Prabhakaran Karunadas, Biswajit Majumder, Satyendra Tiwari, Sivabalan Maduramuthu, Rakesh Gupta, P.P. Mohanan, Kalaivani Mani, J. Ezhilan, Rahul Patil, K.R. Subramanyam, Santanu Guha, Saumitra Ray, Dinesh Choudhary, Rathinavel Sivakumar, Rituparna Baruah, Bishwa Bhushan Bharti, Santhosh Krishnappa, Manish Bansal, Rambhatla Suryanarayana Murty, Uday Jadhav, Prafulla Kerker, Siddiqui Kkh, Bateshwar Prasad Singh, Pradeep K. Hasija, Cholenahally Nanjappa Manjunath, Seemala Saikrishna Reddy, Karthik Tummala, Ashok Goyal, Natesh Bangalore Hanumanthappa, Sudeep Kumar, Ramakrishnan Sivasubramanian, Shashi Shekhar Chatterjee, Varun Shankar Narain, Diapk Sarma, Vitull K. Gupta, Sharad Chandra, Harsh Wardhan, Jayagopal Pathiyil Balagopalan, Rakesh Yadav, Girish Meennahalli Palleda, Vijay Kumar Garg, Pradip Kumar Deb, Sanjay Tyagi, C. B. Meena, Amit Malviya, Rishi Sethi, Ranjit Kumar Nath, Dorairaj Prabhakaran, Rabindra Nath Chakraborthy, A. Jabir, Pranab Jyoti Bhattacharyya, Manoranjan Mandal, Satish Kumar, Kumar Kenchappa, Mohit Gupta |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_treatment Myocardial Infarction 030204 cardiovascular system & hematology Logistic regression Ventricular Function Left 0302 clinical medicine Pandemic 030212 general & internal medicine Myocardial infarction Non-ST Elevated Myocardial Infarction Mortality rate Middle Aged Low-and middle-income country Acute myocardial infarction (AMI) Patient volume Non ST elevation Myocardial infarction (NSTEMI) and outcome Female Original Article Acute coronary syndrome Cardiology and Cardiovascular Medicine medicine.medical_specialty Coronavirus disease 2019 (COVID-19) RD1-811 India COVID-19 pandemic 03 medical and health sciences LMIC Percutaneous Coronary Intervention medicine Humans Diseases of the circulatory (Cardiovascular) system Pandemics Management practices Aged business.industry COVID-19 Percutaneous coronary intervention Stroke Volume medicine.disease Cross-Sectional Studies RC666-701 Communicable Disease Control Time course Emergency medicine ST Elevation Myocardial Infarction Surgery business ST elevation Myocardial infarction (STEMI) Demography |
| Zdroj: | Indian Heart Journal, Vol 73, Iss 4, Pp 413-423 (2021) Indian Heart Journal |
| ISSN: | 0019-4832 |
| Popis: | Background: Admissions for acute myocardial infarction (MI) have declined significantly during the COVID-19 pandemic. The changes in the presentation, management, and outcomes of MI during the pandemic period are not well recognized, and data from low- and middle-income countries are limited. Methods: In this two-timepoint cross-sectional study involving 187 hospitals across India, patients admitted with MI between 15th March to 15th June in 2020 were compared with those admitted during the corresponding period of 2019. We sought to determine the changes in the number of admissions, management practices, and outcomes. Findings: We included 41,832 consecutive adults with MI. Admissions during the pandemic period (n = 16414) decreased by 35·4% as compared to the corresponding period in 2019 (n = 25418). We observed significant heterogeneity in this decline across India with the North zone reporting greater decline (-44·8%) than the South zone (-27·7%). The weekly average decrease in MI admissions in 2020 which peaked around the mid- study period, correlated negatively with the number of COVID cases (r = -0·48; r 2 = 0·2), but strongly correlated with the stringency of lockdown index (r = 0·95; r 2 = 0·90). On a multi-level logistic regression, admissions were lower in 2020 with older age categories, tier 1 cities, and centers with high patient volume, and teaching programs. Adjusted utilization rate of coronary angiography, and percutaneous coronary intervention decreased by 11·3%, and 5·9% respectively. However, the in-hospital mortality rates did not differ. Interpretation: The magnitude of reduction in MI admissions across India was not uniform. The nature, time course, and the patient demographics were different compared to reports from other countries, suggesting a significant impact due to the lockdown. These findings have important implications in managing MI admissions during the pandemic. Funding Statement: The study is funded by cardiological society of India. Declaration of Interests: Nothing to declare for all the authors. Ethics Approval Statement: Individual participating centres either obtained an ethical approval from respective Institutional ethics committees or a no objection certificate from the administration. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|