TY - JOUR
T1 - Impact of COVID-19 on incidence and outcomes of post-infarction mechanical complications in Europe
AU - Ronco, Daniele
AU - Matteucci, Matteo
AU - Ravaux, Justine Mafalda
AU - Kowalewski, Mariusz
AU - Massimi, Giulio
AU - Torchio, Federica
AU - Trumello, Cinzia
AU - Naito, Shiho
AU - Bonaros, Nikolaos
AU - De Bonis, Michele
AU - Fina, Dario
AU - Kowalówka, Adam
AU - Deja, Marek
AU - Jiritano, Federica
AU - Serraino, Giuseppe Filiberto
AU - Kalisnik, Jurij Matija
AU - De Vincentiis, Carlo
AU - Ranucci, Marco
AU - Fischlein, Theodor
AU - Russo, Claudio Francesco
AU - Carrozzini, Massimiliano
AU - Boeken, Udo
AU - Kalampokas, Nikolaos
AU - Golino, Michele
AU - De Ponti, Roberto
AU - Pozzi, Matteo
AU - Obadia, Jean-François
AU - Thielmann, Matthias
AU - Scrofani, Roberto
AU - Blasi, Stefania
AU - Troise, Giovanni
AU - Antona, Carlo
AU - De Martino, Andrea
AU - Falcetta, Giosuè
AU - Actis Dato, Guglielmo
AU - Severgnini, Paolo
AU - Musazzi, Andrea
AU - Lorusso, Roberto
PY - 2023/12/5
Y1 - 2023/12/5
N2 - 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.
AB - 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.
KW - Acute myocardial infarction
KW - COVID-19
KW - Cardiac rupture
KW - Papillary muscle rupture
KW - Ventricular septal rupture
U2 - 10.1093/icvts/ivad198
DO - 10.1093/icvts/ivad198
M3 - Article
SN - 2753-670X
VL - 37
JO - Interdisciplinary CardioVascular and Thoracic Surgery
JF - Interdisciplinary CardioVascular and Thoracic Surgery
IS - 6
M1 - ivad198
ER -