Impact of COVID-19 on incidence and outcomes of post-infarction mechanical complications in Europe

Archive ouverte

Deja, M. | Jiritano, F. | Serraino, G. F. | Kalisnik, J. M. | de Vincentiis, C. | Ranucci, M. | Fischlein, T. | Russo, C. F. | Carrozzini, M. | Boeken, U. | Kalampokas, N. | Golino, M. | de Ponti, R. | Pozzi, M. | Obadia, J. F. | Thielmann, M. | Scrofani, R. | Blasi, S. | Troise, G. | Antona, C. | de Martino, A. | Falcetta, G. | Actis Dato, G. | Severgnini, P. | Musazzi, A. | Lorusso, R. | Ronco, D. | Matteucci, M. | Ravaux, J. M. | Kowalewski, M. | Massimi, G. | Torchio, F. | Trumello, C. | Naito, S. | Bonaros, N. | de Bonis, M. | Fina, D. | Kowalówka, A.

Edité par CCSD -

International audience. OBJECTIVES: Post-acute myocardial infarction mechanical complications (post-AMI MCs) represent rare but life-threatening conditions, including free-wall rupture, ventricular septal rupture and papillary muscle rupture. During the coronavirus disease-19 (COVID-19) pandemic, an overwhelming pressure on healthcare systems led to delayed and potentially suboptimal treatments for time-dependent conditions. As AMI-related hospitalizations decreased, limited information is available whether higher rates of post-AMI MCs and related deaths occurred in this setting. This study was aimed to assess how COVID-19 in Europe has impacted the incidence, treatment and outcome of MCs. METHODS: The CAUTION-COVID19 study is a multicentre retrospective study collecting 175 patients with post-AMI MCs in 18 centres from 6 European countries, aimed to compare the incidence of such events, related patients' characteristics, and outcomes, between the first year of pandemic and the 2 previous years. RESULTS: A non-significant increase in MCs was observed [odds ratio (OR) = 1.15, 95% confidence interval (CI) 0.85-1.57; P = 0.364], with stronger growth in ventricular septal rupture diagnoses (OR = 1.43, 95% CI 0.95-2.18; P = 0.090). No significant differences in treatment types and mortality were found between the 2 periods. In-hospital mortality was 50.9% and was higher for conservatively managed cases (90.9%) and lower for surgical patients (44.0%). Patients admitted during COVID-19 more frequently had late-presenting infarction (OR = 2.47, 95% CI 1.24-4.92; P = 0.010), more stable conditions (OR = 2.61, 95% CI 1.27-5.35; P = 0.009) and higher EuroSCORE II (OR = 1.04, 95% CI 1.01-1.06; P = 0.006). CONCLUSIONS: A non-significant increase in MCs incidence occurred during the first year of COVID-19, characterized by a significantly higher rate of late-presenting infarction, stable conditions and EuroSCORE-II if compared to pre-pandemic data, without affecting treatment and mortality.

• Description
• Sujet/Public
• Outil
• Outil d'anticipation
• Mémoire et thèse
• Gestion