Clinical Characteristics and In-Hospital Mortality in Patients with STEMI during the COVID-19 Outbreak in Thailand
Piyoros Lertsanguansinchai,
Ronpichai Chokesuwattanaskul,
Thitima Limjaroen,
Chaisiri Wanlapakorn,
Vorarit Lertsuwunseri,
Siriporn Athisakul,
Jarkarpun Chaipromprasit,
Wasan Udayachalerm,
Wacin Buddhari,
Suphot Srimahachota
Affiliations
Piyoros Lertsanguansinchai
Division of Cardiovascular Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University and Cardiac Center, King Chulalongkorn Memorial Hospital, Thai Red Cross, Bangkok 10330, Thailand
Ronpichai Chokesuwattanaskul
Division of Cardiovascular Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University and Cardiac Center, King Chulalongkorn Memorial Hospital, Thai Red Cross, Bangkok 10330, Thailand
Thitima Limjaroen
Division of Cardiovascular Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University and Cardiac Center, King Chulalongkorn Memorial Hospital, Thai Red Cross, Bangkok 10330, Thailand
Chaisiri Wanlapakorn
Division of Cardiovascular Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University and Cardiac Center, King Chulalongkorn Memorial Hospital, Thai Red Cross, Bangkok 10330, Thailand
Vorarit Lertsuwunseri
Division of Cardiovascular Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University and Cardiac Center, King Chulalongkorn Memorial Hospital, Thai Red Cross, Bangkok 10330, Thailand
Siriporn Athisakul
Division of Cardiovascular Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University and Cardiac Center, King Chulalongkorn Memorial Hospital, Thai Red Cross, Bangkok 10330, Thailand
Jarkarpun Chaipromprasit
Division of Cardiovascular Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University and Cardiac Center, King Chulalongkorn Memorial Hospital, Thai Red Cross, Bangkok 10330, Thailand
Wasan Udayachalerm
Department of Physiology, Faculty of Medicine, Chulalongkorn University and Cardiac Center, King Chulalongkorn Memorial Hospital, Thai Red Cross, Bangkok 10330, Thailand
Wacin Buddhari
Division of Cardiovascular Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University and Cardiac Center, King Chulalongkorn Memorial Hospital, Thai Red Cross, Bangkok 10330, Thailand
Suphot Srimahachota
Division of Cardiovascular Medicine, Department of Medicine, Faculty of Medicine, Chulalongkorn University and Cardiac Center, King Chulalongkorn Memorial Hospital, Thai Red Cross, Bangkok 10330, Thailand
Background: Nowadays, current evidence on the effects of the COVID-19 outbreak on ST-elevation myocardial infarction (STEMI) patients is discrepant. The aim of this study was to compare and identify any changes in STEMI patients between the pre-COVID-19 period and during the COVID-19 outbreak. Methods: We conducted a retrospective cohort study to evaluate consecutive STEMI patients admitted from 1 September 2018 to 30 September 2021. We designated 14 March 2020 as the commencement of the COVID-19 outbreak in Thailand. Results: A total of 513 consecutive STEMI patients were included in this study: 330 (64%) admitted during the pre-COVID-19 outbreak period and 183 (36%) admitted during the COVID-19 outbreak. There was a significant 45% decline in the number of STEMI cases admitted during the COVID-19 outbreak period. During the outbreak, STEMI patients had significantly increased intra-aortic balloon pump (IABP) insertion (23% vs. 15%, p-value = 0.004), higher high-sensitivity troponin T level (11,150 vs. 5213, p-value p-value p-value = 0.020), FMC-to-wire-crossing time (39 vs. 23 min, p-value p-value = 0.005) were increased in STEMI patients during the outbreak compared with pre-outbreak. There was no statistical difference in in-hospital mortality between both periods (p-value = 0.639). Conclusions: During the COVID-19 outbreak, there was a significant decline in the total number of admitted STEMI cases. Unfortunately, the time-to-diagnosis, pain-to-FMC time, FMC-to-wire-crossing time, and pain-to-wire-crossing time were significantly delayed during the COVID-19 outbreak. However, in-hospital mortality showed no significant differences between these two time periods. Highlights: 45% decline in the number of STEMI cases admitted and a significant delay in the treatment timeline during the COVID-19 outbreak. In-hospital mortality showed no significant difference between these two periods. Our study will motivate healthcare professionals to optimize treatments, screenings, and infectious control protocols to reduce the time from the onset of chest pain to wire crossing in STEMI patients during the outbreak.
