PMC:7242185 / 4334-8564 JSONTXT

{"target":"https://pubannotation.org/docs/sourcedb/PMC/sourceid/7242185","sourcedb":"PMC","sourceid":"7242185","source_url":"https://www.ncbi.nlm.nih.gov/pmc/7242185","text":"Results\nPatient characteristics are shown in Table 1 . A total of 246 ACS-patients were included in the study (162 patients with ACS admitted in March 2019, and 84 patients with ACS admitted in March 2020). During the case period, a total of 84 hospital admissions for ACS were observed, accounting for an IR of 2.7 admissions per day vs an IR of 5.2 admissions per day observed in the control period (odds ratio [OR], 0.52; 95% confidence interval [CI], 0.39-0.67; P \u003c 0.001). Of the 84 patients with ACS in 2020, 26 were positive for COVID-19; of these, 5 patients were already hospitalized for interstitial pneumonia, whereas—in the remaining 21 cases—the diagnosis of COVID-19 infection was an incidental finding from the routine COVID reverse transcription polymerase chain reaction (RT-PCR) assay of a nasal swab performed immediately at admission before cardiac catheterization.\nTable 1 Patients clinical characteristics and acute clinical outcome\nGroup 2019162 patients Group 202084 patients P value Group I 2019162 patients Group II 202084 patients P value\nAGE 69.9 + 32.6 68.3 + 30.9 ns STEMI 59 (36.4%) 34 (40.5%) ns\nSEX M:113/F:49 M:62/F:22 ns STEMI rr \u003e 24 hours 7 (4.3%) 15 (17.8%) \u003c 0.001\nCOPD 35 (21.6%) 7 (8.3%) \u003c 0.01 NSTEMI 93 (57.4%) 33 (39.3%) \u003c 0.01\nHYPERTENSION 108 (66.7%) 65 (77.4%) ns Others ACS 3 (1.9%) 2 (2.4%) \u003c 0.01\nDIABETES 48 (29.6%) 31 (36.9%) ns Door to balloon (STEMI) 40 + 12 (minutes) 66 + 17 (minutes) \u003c 0.001\nSMOKING 85 (52.5%) 34 (40.5%) ns Symptoms to PCI (STEMI) 3.9 + 2.2 (hours) 5.8 + 3.1 (hours) \u003c 0.001\nDYSLIPIDEMIA 100 (61.7%) 58 (69%) ns Symptoms to PCI (NSTEMI) 18.8 + 20 (hours) 36.9 + 38.4 (hours) \u003c 0.001\nBMI \u003e 30 36 (22.2%) 23 (27.4%) ns hs-cTnI (basal) 1142 + 4017 5138 + 9408 \u003c 0.001\nKNOWN CAD 41 (25.3%) 31 (36.9%) ns hs-cTnI (peak) 9143 + 13,825 13,681 + 10,936 \u003c 0.01\nAF 18 (11.1%) 6 (7.1%) ns LVEF 48.9 + 9.4 45.9 + 12 \u003c 0.05\nCKD 21 (13%) 12 (14.3%) ns LVEF \u003c 40% 24.7% 42.8% \u003c 0.01\nGRACE SCORE 116 + 26 126 + 27 \u003c 0.01 Death 1.8% 4.7% ns\nOther ACS (Tako-Tsubo syndrome or myocardial infarction with nonobstructive coronary arteries [MINOCA]).\nAF, atrial fibrillation; ACS, acute coronary syndrome; BMI, body mass index; CAD, coronary artery disease; CKD, chronic kidney disease; COPD, chronic obstructive pulmonary disease; GRACE, Global Registry of Acute Coronary Events; hs-cTnI, high-sensitivity cardiac troponin I (lab range 0-58 ng/L); LVEF, left-ventricular ejection fraction; NSTEMI, non–ST-elevation myocardial infarction; rr, recommended reperfusion; PCI, percutaneous coronary intervention; rr, recommended reperfusion; STEMI, ST-elevation myocardial infarction.\nThere were no significant differences in patient clinical characteristics or risk factors in the 2 groups. In March 2019, NSTEMI was a more frequent admission diagnosis (57.4% vs 39.3%, P \u003c 0.01) and symptom to PCI was significantly shorter (18.8 + 20 vs 36.9 + 38.4 hours, P \u003c 0.001). In the STEMI subgroup, door-to-balloon and symptoms-to-balloons were significantly higher in March 2020 (66 + 17 vs 40 + 12 minutes, P \u003c 0.001 and 5.8 + 3.1 hours vs 3.9 + 2.2 hours, P \u003c 0.001 [Fig. 1 ]) with a delay from symptoms to wiring for STEMI PCI \u003e 24 hours more frequently in March 2020 (17.8% vs 4.3%, P \u003c 0.001). The Global Registry of Acute Coronary Events (GRACE) score was significantly higher in 2020 (126 + 27 vs 116 + 26, P \u003c 0.001), and more patients were in the higher European Society of Cardiology (ESC) tertile predictive of higher in-hospital and 6-month mortality (GRACE score above 140: 33.3% vs 18.5, P \u003c 0.01, and GRACE score above 118: 59.6 vs 44.4%, P \u003c 0.05).\nFigure 1 Graph bar shows the difference in door-to-balloon, symptoms-to-percutaneous coronary intervention, basal and peak in high-sensitivity troponin I between the 2 groups. ∗P \u003c 0.001.∗∗P \u003c 0.01\nIn-hospital clinical outcome is summarized in Table 2. Admission and peak high sensitivity troponin were significantly higher in 2020 (5138 + 9408 vs 1142 + 4017 ng/L, P \u003c 0.001, 13,681 + 10,936 vs 9143 + 13,825 ng/L, P \u003c 0.01 [Fig. 1]). Presence of an LVEF \u003c 40% at discharge was more frequent in March 2020 (42.8% vs 24.7%, P \u003c 0.01). No statistical difference in in-hospital mortality was observed between the 2 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