Where Did All the Acute Myocardial Infarctions Go? Fewer Presentations During the Initial Wave of the COVID-19 Pandemic
Presenter
Nina Talmor, M.D, New York University Langone Medical Center, New York, NY
Nina Talmor, M.D1, Shari Brosnahan, M.D.1, Binita Shah, M.D., FSCAI2, Sripal Bangalore, MD, MHA, FSCAI1, Louai Razzouk, M.D., M.P.H., FSCAI1, Michael Attubato, M.D.1, Frederick Feit, M.D.1, Craig A. Thompson, M.D.1 and Nathaniel Rosso Smilowitz, MD, MSc3, (1)New York University Langone Medical Center, New York, NY, (2)NYU Grossman School of Medicine, New York, NY, (3)NYU Langone Medical Center, New York, NY
Keywords: Acute Coronary Syndromes (ACS), COVID-19 and Complications
Background The response to the novel coronavirus (COVID-19) pandemic in New York City required profound changes in healthcare delivery. Characteristics and outcomes of patients with acute myocardial infarction (AMI) during the peak of the pandemic are described herein.
Methods We conducted a single-center retrospective observational study comparing patients with MI who underwent urgent invasive coronary angiography at NYU Langone Health in April 2020, during the peak of the pandemic, versus those presenting in April 2019, prior to the pandemic.
Results Only 13 patients with AMI (2/13 tested were COVID-19 positive) underwent invasive angiography in 2020, compared to 59 in 2019. No differences in demographics, comorbidities, or baseline medications were identified between the two time periods. There was a numerically greater proportion of STEMI presentations (39% vs 20%, p=0.30) and a longer median delay from symptom onset to hospital presentation (70.7 vs 34.2 hours, p=0.06) in 2020 versus 2019. Multivessel coronary disease was less common (31% vs 73%, p=0.01) but peak troponin concentrations were higher (83.92 vs. 19.49 ng/mL, p = 0.01) in 2020 versus 2019.
Conclusions The dramatic decrease in the number of patients presenting with AMI and delayed time to presentation during the peak of the pandemic indicate the need for improved public health messaging to ensure timely and appropriate cardiovascular care. Public education
regarding measures to provide safe access to healthcare during the pandemic are warranted.
