Acute coronary syndrome outside and during the COVID-19 pandemic

Abstract

Objective To analyze the register of patients with acute coronary syndrome (ACS) at the clinical cardiological dispensary from september to november 2018–2019 and 2020 during COVID-19. Materials and methods A retrospective study was conducted, the registry included 952 patients with ACS in 2018 and 1033 patients in 2019, as well as 964 patients in 2020 during the COVID-19 pandemic. Statistical analysis of the material was performed using the Statistica 11.0 software. Results When analyzing the provision of specialized care to patients with ACS in 2018, the average age of patients was 67 years, the mortality rate was 3.94%. The structure of ACS in 2018 was dominated by patients with ST-segment elevation myocardial infarction (STEMI) - 47%, myocardial infarction without ST-segment elevation (STEMI) occurred in 23%. The proportion of patients with unstable angina pectoris (NS) was 30%. Only 43.6% were registered with coronary heart disease (CHD) before ACS. 12.5% had a history of diabetes mellitus (DM), 31.2% had arterial hypertension (AH). This cardiovascular event recurred in 4% of patients. Average bed-days 9.73. In 2019, the average age of patients was 68 years, the mortality rate was 4.35%. In the structure of ACS in 2019, patients with STEMI were more common 47.5% than with STEMI 28%. The proportion of patients with HC was 24.5%. 52.1% of patients were registered at the dispensary before ACS with a diagnosis of coronary artery disease. A history of diabetes mellitus was in 13.0%, AH in 39.6% of patients. For 3.8% of patients, myocardial infarction in 2019 became recurrent. The average bed-days was 9.92. In 2020, the average age of patients was 66 years, the mortality rate was 6.25%. The structure of patients was dominated by patients with STEMI - 50.5%, STEMI was less common - in 17.5%. The proportion of patients with unstable angina pectoris was 32%. It was revealed that 54.4% were registered in the dispensary before ACS with coronary artery disease. 28.5% had a history of diabetes mellitus, 40.8% - AH. This event was repeated for 4.7% of patients. Average rate, bed-days rate is 8.85. Conclusions Initial analysis reveals that the group of patients with ACS in 2020 was younger than the group of patients in 2019–2020. ACS in combination with diabetes during the pandemic occurred 2 times more often than in the same period of 2018–2019. The proportion of patients registered with the dispensary increased over the period 2018–2019–2020, however, the mortality rate in the 2020 group had a clear upward trend, which may be due to various reasons, incl. the COVID-19 pandemic. The average number of bed-days also objectively decreased when comparing the 2020 and 2019–2018 patient cohorts, which may be due to the burden on the healthcare system during the pandemic. Funding Acknowledgement Type of funding sources: Public hospital(s). Main funding source(s): Clinical Cardiology Dispensary