Incidence and outcome of myocardial infarction treated with percutaneous coronary intervention during COVID-19 pandemic

Research output: Contribution to journalArticle

Abstract

Objective Most reports on the declining incidence of myocardial infarction (MI) during the COVID-19 have either been anecdotal, survey results or geographically limited to areas with lockdowns. We examined the incidence of MI during the COVID-19 pandemic in Sweden, which has remained an open society with a different public health approach fighting COVID-19. Methods We assessed the incidence rate (IR) as well as the incidence rate ratios (IRRs) of all MI referred for coronary angiography in Sweden using the nationwide Swedish Coronary Angiography and Angioplasty Registry (SCAAR), during the COVID-19 pandemic in Sweden (1 March 2020-7 May 2020) in relation to the same days 2015-2019. Results A total of 2443 MIs were referred for coronary angiography during the COVID-19 pandemic resulting in an IR 36 MIs/day (204 MIs/100 000 per year) compared with 15 213 MIs during the reference period with an IR of 45 MIs/day (254 MIs/100 000 per year) resulting in IRR of 0.80, 95% CI (0.74 to 0.86), p<0.001. Results were consistent in all investigated patient subgroups, indicating no change in patient category seeking cardiac care. Kaplan-Meier event rates for 7-day case fatality were 439 (2.3%) compared with 37 (2.9%) (HR: 0.81, 95% CI (0.58 to 1.13), p=0.21). Time to percutaneous coronary intervention (PCI) was shorter during the pandemic and PCI was equally performed, indicating no change in quality of care during the pandemic. Conclusion The COVID-19 pandemic has significantly reduced the incidence of MI referred for invasive treatment strategy. No differences in overall short-term case fatality or quality of care indicators were observed.

Details

Authors
  • Sasha Koul
  • Matthias Go Tberg
  • Patrik Tydén
  • Erik Rydberg
  • Joakim Alfredsson
  • Peter Vasko
  • Elmir Omerovic
  • Oskar Angerås
  • Ole Fröbert
  • Fredrik Calais
  • Sebastian Völz
  • Anders Ulvenstam
  • Dimitrios Venetsanos
  • Jonas Oldgren
  • Giovanna Sarno
  • Per Grimfjärd
  • Jonas Persson
  • Nils Witt
  • Bertil Lindahl
  • Stefan K. James
Organisations
External organisations
  • Skåne University Hospital
  • Linköping University
  • Växjö Central Hospital
  • Halmstad County Hospital
  • Örebro University
  • Östersund Hospital
  • Karolinska University Hospital
  • Uppsala University Hospital
  • Karolinska Institutet
  • Västmanland Hospital
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Cardiac and Cardiovascular Systems

Keywords

  • acute myocardial infarction, epidemiology
Original languageEnglish
Pages (from-to)1812-1818
Number of pages7
JournalHeart
Volume106
Issue number23
Publication statusPublished - 2020
Publication categoryResearch
Peer-reviewedYes