Health care quality and changes in the clinical characteristics of patients with non-ST elevation acute coronary syndrome in a regional vascular center during the COVID-19 pandemic

Abstract

Aim. To perform a comparative assessment of the clinical and demographic characteristics of patients with non-ST elevation acute coronary syndrome (NSTE-ACS) and health care quality during the coronavirus disease 2019 (COVID-19) pandemic.Material and methods. Data obtained from medical records were used. Statistical processing was performed using the Statistica 10.0 software package. The analysis included patients with NSTE-ACS treated in 2020 (n=524) and 2019 (n=395). The group for further analysis consisted of patients with non-ST elevation myocardial infarction treated in 2020 (n=233) compared to 2019 (n=221).Results. An increase in the relative number of patients with unstable angina in the NSTE-ACS group was revealed. COVID-19 was verified in 5,5% of patients with NSTE-ACS. Of these, pneumonia was diagnosed in 10 (34,5%) patients, while 11 (37,9%) patients were transferred to pulmonary hospitals. The remaining 18 (62,1%) patients were discharged for outpatient treatment. Infected patients had a higher risk of in-hospital mortality according to the Global Registry of Acute Coronary Events (GRACE) score relative to general cohort of patients — 2,0 (1,0; 9,0) vs 1,0 (0,8; 3,0) (p=0,04). In addition, 215 (92,3%) patients underwent invasive coronary angiography, which is higher than in 2019 (78,7%) (p<0,001). An increase in revascularization prevalence in patients ≥75 years old was found (p=0,01).Conclusion. COVID-19 pandemic has led to a change in the clinical characteristics of patients, while not having a significant impact on the scope of endovascular interventions and health care quality for patients with NSTE-ACS in the emergency cardiology department.

Keywords

• острый коронарный синдром
• чрескожное коронарное вмешательство
• инфаркт миокарда
• covid-19
• регистр