1. Changing pattern of admissions for acute myocardial infarction in India during the COVID-19 pandemic
- Author
-
Geevar Zachariah, Sivasubramanian Ramakrishnan, Mrinal Kanti Das, Abdullakutty Jabir, Pathiyil Balagopalan Jayagopal, Krishnannair Venugopal, Kalaivani Mani, Amal Kumar Khan, Amit Malviya, Anshul Gupta, Ashok Goyal, B.P. Singh, Bishav Mohan, Bishwa Bhushan Bharti, Biswajit Majumder, Bivin Wilson, Chakkalakkal Prabhakaran Karunadas, Chandra Bhan Meena, Cholenahally Nanjappa Manjunath, Mathew Cibu, Debabrata Roy, Dinesh Choudhary, Dipak Ranjan Das, Dipak Sarma, Meennahalli Palleda Girish, Gurpreet Singh Wander, Harsh Wardhan, Janakiraman Ezhilan, Karthik Tummala, Virender Kumar Katyal, Kewal Goswami, Kodangala Subramanyam, Krishna Kishore Goyal, Kenchappa Kumar, Lekha Adik Pathak, Manish Bansal, Manoranjan Mandal, Mohit Dayal Gupta, Narendra Nath Khanna, Natesh Bangalore Hanumanthappa, Neil Bardoloi, Nitin Modi, Nitish Naik, Pradeep K. Hasija, Prafulla Kerkar, Pranab Jyoti Bhattacharyya, Pushkraj Gadkari, Rabindra Nath Chakraborthy, Rahul Raosaheb Patil, Rakesh Gupta, Rakesh Yadav, Rambhatla Suryanarayana Murty, Ranjit Kumar Nath, Rathinavel Sivakumar, Rishi Sethi, Rituparna Baruah, Sanjay Tyagi, Santanu Guha, Santhosh Krishnappa, Satish Kumar, Satya Narayan Routray, Satyendra Tewari, Saumitra Ray, Seemala Saikrishna Reddy, Sharad Chandra, Shashi Bhushan Gupta, Shashi Shekhar Chatterjee, K.K.H. Siddiqui, Maduramuthu Sivabalan, Sreekanth Yerram, Sudeep Kumar, Swaminathan Nagarajan, Tom Devasia, Uday Jadhav, Varun Shankar Narain, Vijay Kumar Garg, Vitull K. Gupta, Dorairaj Prabhakaran, Pradip Kumar Deb, and Padinhare Purayil Mohanan
- Subjects
Acute myocardial infarction (AMI) ,LMIC ,Low-and middle-income country ,COVID-19 pandemic ,Acute coronary syndrome ,ST elevation Myocardial infarction (STEMI) ,Surgery ,RD1-811 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Aim: Studies on the changes in the presentation and management of acute myocardial infarction (AMI) during the COVID-19 pandemic from low- and middle-income countries are limited. We sought to determine the changes in the number of admissions, management practices, and outcomes of AMI during the pandemic period in India. Methods & Results: In this two-timepoint cross-sectional study involving 187 hospitals across India, patients admitted with AMI between 15th March to 15th June in 2020 were compared with those admitted during the corresponding period of 2019.We included 41,832 consecutive adults with AMI. Admissions during the pandemic period (n = 16414) decreased by 35·4% as compared to the corresponding period in 2019 (n = 25418). We observed significant heterogeneity in this decline across India. The weekly average decrease in AMI admissions in 2020 correlated negatively with the number of COVID cases (r = −0·48; r2 = 0·2), but strongly correlated with the stringency of lockdown index (r = 0·95; r2 = 0·90). On a multi-level logistic regression, admissions were lower in 2020 with older age categories, tier 1 cities, and centers with high patient volume. Adjusted utilization rate of coronary angiography, and percutaneous coronary intervention decreased by 11·3%, and 5·9% respectively. Conclusions: The magnitude of reduction in AMI admissions across India was not uniform. The nature, time course, and the patient demographics were different compared to reports from other countries, suggesting a significant impact due to the lockdown. These findings have important implications in managing AMI during the pandemic.
- Published
- 2021
- Full Text
- View/download PDF