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Impact of public health emergency response to COVID‐19 on management and outcome for NSTEMI patients in Beijing: A single‐center historic control
Author(s) -
Liu Shuai,
Song Chenxi,
Yin Dong,
Wang Yang,
Zhao Yanyan,
Yang Weixian,
Qiao Shubin,
Dou Kefei,
Xu Bo
Publication year - 2021
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.29145
Subject(s) - medicine , mace , percutaneous coronary intervention , myocardial infarction , conventional pci , chest pain , emergency department , single center , cardiology , heart failure , emergency medicine , psychiatry
Background During coronavirus disease 2019 (COVID‐19) epidemic, reducing the number of invasive procedure and choosing conservative medication strategy for patients with non‐ST‐segment elevation myocardial infarction (NSTEMI) is unavoidable. Whether this relatively conservative strategy will impact in‐hospital outcome for NSTEMI patients remains unclear. Methods and Results The current study included all consecutive NSTEMI patients who visited the emergency department in Fuwai Hospital from February 1 to March 31, 2020 and all the NSTEMI patients in the same period of 2019 as a historical control. Very‐high‐risk patients were defined as clinical presentation of heart failure, cardiac shock, cardiac arrest, recurrent chest pain, and life‐threatening arrhythmias. The primary outcome was in‐hospital major adverse cardiac events (MACE), defined as a composite of all‐cause death, recurrent myocardial infarction, or heart failure. A total of 115 NSTEMI patients were enrolled since the outbreak of COVID‐19, and a total of 145 patients were included in the control group. There was a tendency toward higher MACE risk in 2020 compared with 2019 (18.3% vs. 11.7%, p = .14). Among very‐high‐risk patients, early percutaneous coronary intervention (PCI) strategy in 2019 was associated with reduced MACE risk compared with delayed PCI in 2020 (60.6% [20/33] in 2020 vs. 27.9% [12/43] in 2019, p = .01). Conclusions COVID‐19 pandemic results in a significant reduction in immediate/early PCI and a trend toward higher adverse event rate during hospitalization, particular in very‐high‐risk patients.