Study Finds Decline in Heart Attack Treatment During Pandemic

Consequences for untreated STEMI patients following the COVID-19 pandemic could include increased mortality, heart failure, and morbidities.

New findings from a nationwide study analyzing rates of percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI) in parallel with COVID-19 surges has found that STEMI PCI cases decreased sharply by nearly 30% following the onset of the COVID-19 pandemic.

According to results being presented at the Society for Cardiovascular Angiography and Interventions 2022 Scientific Sessions, the rates of STEMI PCI cases have still not recovered from pre-pandemic levels. STEMI is a medical emergency associated with a high risk of serious complications including death. Seeking care within the first 90 minutes of symptom onset is critical and delayed care can lead to complications or increased mortality.

Data for the study were abstracted from the Ascension Health System’s internal NCDR CathPCI registry between March 2018 and June 2021 across 42 centers throughout the country. Timing of the COVID-19 pandemic was assessed by COVID-19 prevalence at the county-level and a segmented regression analysis was performed with a monthly interrupted time series.

This regression analysis used a linear regression model to quantify expected STEMI PCIs before and after pandemic onset. The predicted number of PCIs for STEMI was compared to predictions if COVID-19 had not occurred in order to evaluate the differences in STEMI volumes.

According to the study, STEMI PCI trends increased until the pandemic was declared in March 2020 and a rapid decrease was seen in April 2020. After that, STEMI PCIs rose consistently until December 2020, which the researchers defined as the second surge of COVID-19. The decrease of STEMI PCIs was less severe during this period.

The segmented regression found 194 STEMI PCIs within the Ascension Health System each month, with a month-to-month increase of 2 cases. After the pandemic was declared, STEMI PCI rates decreased by 39 per month.

“Our network of PCI centers across the country gives us unique access to data that independent centers may not have,” said lead author Manoj Thangam, MD, an interventional cardiologist at Ascension Texas Cardiovascular, in a press release. “Despite STEMI rates rising, we’ve never gotten back to our pre-COVID baseline, which probably tells us there is still hesitation to come to the hospital despite having a major heart attack.”

The investigators noted that there is an ongoing need for analysis of other potential consequences and ramifications for untreated STEMI patients. These consequences could include increased mortality, heart failure, and morbidities following the COVID-19 pandemic, according to the study findings.

REFERENCE

Nationwide study finds significant decline in treatment for heart attacks during pandemic. News release. EurekAlert; May 18, 2022. Accessed May 23, 2022. https://www.eurekalert.org/news-releases/953124