TY - JOUR
T1 - Impact of COVID-19 on incidence and outcomes of post-infarction mechanical complications in Europe
AU - Ronco, D
AU - Matteucci, M
AU - Ravaux, JM
AU - Kowalewski, M
AU - Massimi, G
AU - Torchio, F
AU - Trumello, C
AU - Naito, S
AU - Bonaros, N
AU - De Bonis, M
AU - Fina, D
AU - Kowalówka, A
AU - Deja, M
AU - Jiritano, F
AU - Serraino, GF
AU - Kalisnik, JM
AU - De Vincentiis, C
AU - Ranucci, M
AU - Fischlein, T
AU - Russo, CF
AU - Carrozzini, M
AU - Boeken, U
AU - Kalampokas, N
AU - Golino, M
AU - De Ponti, R
AU - Pozzi, M
AU - Obadia, JF
AU - Thielmann, M
AU - Scrofani, R
AU - Blasi, S
AU - Troise, G
AU - Antona, C
AU - De Martino, A
AU - Falcetta, G
AU - Dato, GA
AU - Severgnini, P
AU - Musazzi, A
AU - Lorusso, R
N1 - Kalisnik, Fischlein: Department of Cardiac Surgery, Cardiovascular Center, Klinikum N€urnberg, Paracelsus Medical University, Nuremberg, Germany
PY - 2023
Y1 - 2023
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. Post-acute myocardial infarction mechanical complications (post-AMI MCs) represent rare, but potentially catastrophic events, including ventricular septal rupture (VSR), left ventricular free-wall rupture (LVFWR) and papillary muscle rupture (PMR) [1].
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. Post-acute myocardial infarction mechanical complications (post-AMI MCs) represent rare, but potentially catastrophic events, including ventricular septal rupture (VSR), left ventricular free-wall rupture (LVFWR) and papillary muscle rupture (PMR) [1].
KW - Acute myocardial infarction
KW - Cardiac rupture
KW - Ventricular septal rupture
KW - Papillary muscle rupture
KW - COVID-19
KW - MYOCARDIAL-INFARCTION
KW - RUPTURE
KW - HOSPITALIZATIONS
KW - SUPPORT
U2 - 10.1093/icvts/ivad198
DO - 10.1093/icvts/ivad198
M3 - Original Article
C2 - 38109676
SN - 2753-670X
VL - 37
JO - INTERDISCIPLINARY CARDIOVASCULAR AND THORACIC SURGERY
JF - INTERDISCIPLINARY CARDIOVASCULAR AND THORACIC SURGERY
IS - 6
ER -