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oai:ebyu-rdlopen.rawdatalibrary.net:ebyu/132712026-10-18T20:28:06Zopenairedrivercom_ebyu_10000col_ebyu_10001

Treatment delays and in-hospital outcomes in acute myocardial infarction during the COVID-19 pandemic: A nationwide studyErol, Mustafa KemalKayıkçıoğlu, MeralKılıçkap, MustafaGüler, ArdaYıldırım, AbdullahKahraman, FatihCan, Veysiİnci, SinanBaysal, Sadettin SelçukEr, OkanZeybey, UtkuKafkas, ÇağrıYayla, ÇağrıArın, Can BabaAktaş, İbrahimYalçın, Ahmet ArifGenç, ÖmerCosgun, MehmetInanir, MehmetYalçin, Osman YasinGunes, YilmazKurt, Ibrahim HalilAsoglu, RamazanErdol, Mehmet AkifCetin, MustafaErtem, Ahmet GoktuğOrnek, EnderYılmaz Oztekin, Gulsum MeralGenc, AhmetGitmez, MesutAksuyek, SonerAri, HasanGazi, EmineAkray, AnilDeveci, Onur SinanOzturk, OnderCandemir, AytacYavuzgil, OguzBakirci, Eftal MuratDegirmenci, HusnuFedai, HalilBesli, FeyzullahInce, OrhanHancıoglu, EmirhanOflar, ErsanAkurk, Ibrahim FarukÇaglar, Nihan TurhanAylin Yamac Halac, İlke Celikkale HaticeKalyoncuoglu, MuhsinCeneli, DogancanAcute myocardial infarctionCOVID-19PandemicTotal ischemic timeTreatment delayAgedCoronary AngiographyCoronavirus InfectionsEmergency Medical ServicesFemaleHeart FailureHumansMaleMiddle AgedMyocardial InfarctionPandemicsPercutaneous Coronary InterventionPneumonia, ViralPrognosisRegistriesRegression AnalysisShock, CardiogenicST Elevation Myocardial InfarctionTime FactorsTime-to-TreatmentTreatment OutcomeTurkeytroponinacute heart infarctionadultObjective: Delayed admission of myocardial infarction (MI) patients is an important prognostic factor. In the present nationwide registry (TURKMI-2), we evaluated the treatment delays and outcomes of patients with acute MI during the Covid-19 pandemic and compaired with a recent pre-pandemic registry (TURKMI-1). Methods: The pandemic and pre-pandemic studies were conducted prospectively as 15-day snapshot registries in the same 48 centers. The inclusion criteria for both registries were aged ≥18 years and a final diagnosis of acute MI (AMI) with positive troponin levels. The only difference between the 2 registries was that the pre-pandemic (TURKMI-1) registry (n=1872) included only patients presenting within the first 48 hours after symptom-onset. TURKMI-2 enrolled all consecutive patients (n=1113) presenting with AMI during the pandemic period. Results: A comparison of the patients with acute MI presenting within the 48-hour of symptom-onset in the pre-pandemic and pandemic registries revealed an overall 47.1% decrease in acute MI admissions during the pandemic. Median time from symptom-onset to hospital-arrival increased from 150 min to 185 min in patients with ST elevation MI (STEMI) and 295 min to 419 min in patients presenting with non-STEMI (NSTEMI) (p-values <0.001). Door-to-balloon time was similar in the two periods (37 vs. 40 min, p=0.448). In the pandemic period, percutaneous coronary intervention (PCI) decreased, especially in the NSTEMI group (60.3% vs. 47.4% in NSTEMI, p<0.001; 94.8% vs. 91.1% in STEMI, p=0.013) but the decrease was not significant in STEMI patients admitted within 12 hours of symptom-onset (94.9% vs. 92.1%; p=0.075). In-hospital major adverse cardiac events (MACE) were significantly increased during the pandemic period [4.8% vs. 8.9%; p<0.001; age- and sex-adjusted Odds ratio (95% CI) 1.96 (1.20-3.22) for NSTEMI, p=0.007; and 2.08 (1.38-3.13) for STEMI, p<0.001]. Conclusion: The present comparison of 2 nationwide registries showed a significant delay in treatment of patients presenting with acute MI during the COVID-19 pandemic. Although PCI was performed in a timely fashion, an increase in treatment delay might be responsible for the increased risk of MACE. Public education and establishing COVID-free hospitals are necessary to overcome patients' fear of using healthcare services and mitigate the potential complications of AMI during the pandemic. © 2020 by Turkish Society of Cardiology.Turkish Society of Cardiology2020Articlehttps://rdlopen.rawdatalibrary.net/r/ebyu/13271https://doi.org/10.14744/anatoljcardiol.2020.986072149-2263enAnatolian Journal of Cardiologyinfo:eu-repo/semantics/openAccessinfo:eu-repo/semantics/articlehttps://ebyu-rdlopen.rawdatalibrary.net/tr/items/ebyu/13271