Is the Revascularization Strategy and Outcome Different in Patients with
Acute Coronary Syndrome in COVID -19 pandemic Era:A tertiary centre
experience
Abstract
Objectives: Coronavirus disease of 2019 (COVID 19) became a major public
health issue, causing millions of deaths world wide. The burden of COVID
19 pandemics on access to medical care and the treatment of patients
with chronic diseases and acute coronary syndromes (ACS) is not fully
determined yet. . Methods: A total of 239 patients with ACS were
enrolled into the study. Patients were divided into two groups. First
group was prepandemic group consisted of patients admitted at January
and February 2020, before the pandemic. Second group was consisted of
ACS patients admitted through April and May 2020 during pandemic. Both
groups were compared according to demographic properties, blood
chemistry findings, angiographic features, revascularisation strategies
and clinical outcomes. Results: During pandemic period we observed an
increase in total number of patient with ST elevation miyocardial
infarction (STEMI) patients compared to prepandemic period ( 59(45%) vs
32 (29.6%) respectively). Initial high sensitive troponin and CK-MB
levels were statistically higher in the pandemic group patients(1953
pg/ml vs 259 pg/ml for troponın I and 14 ng/ml vs 6ng/ml for CK-MB
p<0.0001, p=0.02 respectively). TYPE 4a myocardial infarction
due to stent thrombosis was more frequent in pandemic group relative top
re-pandemic group (10 vs 0 p=0.003). Post procedural TIMI flow grade was
lower in pandemic group and distal embolization and TIMI thrombus score
were significantly higher in the pandemic group compared top re-pandemic
group (, p=0.001, p=0.02 ,p=0.002 respectively). However; there was no
statistically significant difference in hospital mortality and short
–term all cause mortality, among groups (p>0.05).
Conclusion: We observed that although clinical, laboratory, and
angiographic features were worse in ACS patients admitted during the
pandemic compared to pre-pandemic period, the mortality rate of ACS was
similar. It is important to keep coronary care units open and
fully-functioning during the pandemic.