Long-Term Outcomes of Patients With Late Presentation of ST-Segment Elevation Myocardial Infarction

Cho, Kyung Hoon; Han, Xiongyi; Ahn, Joon Ho; Hyun, Dae Young; Kim, Min Chul; Sim, Doo Sun; Hong, Young Joon; Kim, Ju Han; Ahn, Youngkeun; Hwang, Jin Yong; Oh, Seok Kyu; Soo, Kwang; Choi, Cheol Ung; Hwang, Kyung‐Kuk; Gwon, Hyeon Cheol; investigators, Kamir-Nih registry

doi:10.1016/j.jacc.2021.02.041

Cited by 37 publications

(32 citation statements)

References 21 publications

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“…In a nationwide prospective Korean registry, Hoon and colleagues investigated 624 late-presenting STEMI patients compared with early presenters (<12 h of symptom onset; n = 5202) for 180-day and 3-year mortality. 21 As expected, late presenters had a significantly higher all-cause mortality after 180 days (10.7 vs. 6.8%; P < 0.001) and 3 years (16.2 vs. 10.6%; P < 0.001) attributed in part to fewer percutaneous coronary intervention (PCI) procedures (acute and total) in late presenters. Future studies should determine those late presenters that might benefit from intervention.…”

Section: Clinical Outcomessupporting

confidence: 56%

The year in cardiovascular medicine 2021: acute cardiovascular care and ischaemic heart disease

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Katz

Kaufmann

et al. 2022

European Heart Journal

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Graphical Abstract Graphical Abstract Mechanisms and clinical phenotypes: the potential impact of acute COVID-19 on the heart and its longer-term sequelae. Reprinted with permission from: Friedrich MG, Cooper LT Jr. What we (don’t) know about myocardial injury after COVID-19. Eur Heart J 2021; 42 :1879–1882.

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Section: Clinical Outcomessupporting

confidence: 56%

The year in cardiovascular medicine 2021: acute cardiovascular care and ischaemic heart disease

Price

Katz

Kaufmann

et al. 2022

European Heart Journal

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“…Given the burden of cardiac diseases in healthcare systems globally [ 13 , 14 ], attention to the impact of the COVID-19 pandemic on cardiology patients is justified. Previous studies noticed a decrease in patients presenting with (acute) cardiac conditions and mentioned delays in those patients who eventually did present for hospital care [ 17 , 18 , 19 ], which could lead to worse clinical outcomes [ 20 ].…”

Section: Introductionmentioning

confidence: 99%

The Impact of the COVID-19 Pandemic on Hospital Services for Patients with Cardiac Diseases: A Scoping Review

Lange

Carvalho

Fernandes

et al. 2022

IJERPH

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This study aims to assess the impact of the COVID-19 pandemic on hospital cardiac care, as assessed by performance indicators. Scoping review methodology: performance indicators were extracted to inform on changes in care during January–June 2020. Database searches yielded 6277 articles, of which 838 met the inclusion criteria. After full-text screening, 94 articles were included and 1637 indicators were retrieved. Most of the indicators that provided information on changes in the number of admissions (n = 118, 88%) signaled a decrease in admissions; 88% (n = 15) of the indicators showed patients’ delayed presentation and 40% (n = 54) showed patients in a worse clinical condition. A reduction in diagnostic and treatment procedures was signaled by 95% (n = 18) and 81% (n = 64) of the indicators, respectively. Length of stay decreased in 58% (n = 21) of the indicators, acute coronary syndromes treatment times increased in 61% (n = 65) of the indicators, and outpatient activity decreased in 94% (n = 17) of the indicators related to outpatient care. Telehealth utilization increased in 100% (n = 6). Outcomes worsened in 40% (n = 35) of the indicators, and mortality rates increased in 52% (n = 31). All phases of the pathway were affected. This information could support the planning of care during the ongoing pandemic and in future events.

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“… 14 A recent study also reported that the mortality risk is 1.5 times higher when the patient arrives at the hospital beyond 12 hr after the onset of symptoms than when the patient visits the hospital within 12 hr. 15 Studies comparing the prognosis of patients with AMI according to the use of EMS have been published. 16 However, in patients who visited a hospital where percutaneous coronary intervention (PCI) could not be administered, it is not possible to accurately determine whether EMS were used.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Prognosis According to the Use of Emergency Medical Services in Patients with ST-Segment Elevation Myocardial Infarction

Kim

Jeong

et al. 2022

Yonsei Med J

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Purpose This study aimed to compare long-term clinical outcomes according to the use of emergency medical services (EMS) in patients with ST-segment elevation myocardial infarction (STEMI) who arrived at the hospital within 12 hr of symptom onset. Materials and Methods A total of 13104 patients with acute myocardial infarction were enrolled in the Korea Acute Myocardial Infarction Registry–National Institutes of Health from October 2011 to December 2015. Of them, 2416 patients with STEMI who arrived at the hospital within 12 hr were divided into two groups: 987 patients in the EMS group and 1429 in the non-EMS group. Propensity score matching (PSM) was performed to reduce bias from confounding variables. After PSM, 796 patients in the EMS group and 796 patients in the non-EMS group were analyzed. The clinical outcomes during 3 years of clinical follow-up were compared between the two groups according to the use of EMS. Results The symptom-to-door time was significantly shorter in the EMS group than in the non-EMS group. The EMS group had more patients with high Killip class compared to the non-EMS group. The rates of all-cause death and major adverse cardiac events (MACE) were not significantly different between the two groups. After PSM, the rate of all-cause death and MACE were still not significantly different between the EMS and non-EMS groups. The predictors of mortality were high Killip class, renal dysfunction, old age, long door-to-balloon time, long symptom-to-door time, and heart failure. Conclusion EMS utilization was more frequent in high-risk patients. The use of EMS shortened the symptom-to-door time, but did not improve the prognosis in this cohort.

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Long-Term Outcomes of Patients With Late Presentation of ST-Segment Elevation Myocardial Infarction

Cited by 37 publications

References 21 publications

The year in cardiovascular medicine 2021: acute cardiovascular care and ischaemic heart disease

The year in cardiovascular medicine 2021: acute cardiovascular care and ischaemic heart disease

The Impact of the COVID-19 Pandemic on Hospital Services for Patients with Cardiac Diseases: A Scoping Review

Comparison of Prognosis According to the Use of Emergency Medical Services in Patients with ST-Segment Elevation Myocardial Infarction

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