Korean Circ J.
2024 Nov;54(11):710-723. 10.4070/kcj.2024.0028.
Trends and Outcomes of Acute Myocardial Infarction During the Early COVID-19 Pandemic in the United States: A National Inpatient Sample Study
- Thyagaturu H
1 - Sandhyavenu H2
- Titus A3
- Roma N4
- Gonuguntla K1
- Patel NN5
- Hashem A6
- Abbott JD7
- Balla S1
- Bhatt DL8
- Affiliations
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- 1Department of Cardiology, West Virginia University, Morgantown, WV, USA
- 2Department of Internal Medicine, Weiss Memorial Hospital, Chicago, IL, USA
- 3Department of Internal Medicine, Saint Vincent Hospital, Worcester, MA, USA
- 4Department of Internal Medicine, St. Luke’s University Hospital Network, Bethlehem, PA, USA
- 5Department of Internal Medicine, New York Medical College/Landmark Medical Center, Woonsocket, RI, USA
- 6Department of Internal Medicine, Rochester General Hospital, Rochester, NY, USA
- 7Department of Medicine, Division of Cardiology, Alpert Medical School of Brown University, Providence, RI, USA
- 8Mount Sinai Heart, Icahn School of Medicine at Mount Sinai Health System, New York, NY, USA
- KMID: 2560658
- DOI: http://doi.org/10.4070/kcj.2024.0028
Abstract
- Background and Objectives
There are limited national data on the trends and outcomes of patients hospitalized with acute myocardial infarction (AMI) during the coronavirus disease 2019 (COVID-19) pandemic. We aimed to evaluate the impact of early COVID-19 pandemic on the trends and outcomes of AMI using the National Inpatient Sample (NIS) database.
Methods
The NIS database was queried from January 2019 to December 2020 to identify adult (age ≥18 years) AMI hospitalizations and were categorized into ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI) based on International Classification of Diseases, Tenth Revision, Clinical Modification codes. In addition, the in-hospital mortality, revascularization, and resource utilization of AMI hospitalizations early in the COVID-19 pandemic (2020) were compared to those in the prepandemic period (2019) using multivariate logistic and linear regression analysis.
Results
Amongst 1,709,480 AMI hospitalizations, 209,450 STEMI and 677,355 NSTEMI occurred in 2019 while 196,230 STEMI and 626,445 NSTEMI hospitalizations occurred in 2020. Compared with those in 2019, the AMI hospitalizations in 2020 had higher odds of inhospital mortality (adjusted odds ratio [aOR], 1.27; 95% confidence interval [CI], [1.23–1.32]; p<0.01) and lower odds of percutaneous coronary intervention (aOR, 0.95 [0.92–0.99]; p=0.02), and coronary artery bypass graft (aOR, 0.90 [0.85–0.97]; p<0.01).
Conclusions
We found a significant decline in AMI hospitalizations and use of revascularization, with higher in-hospital mortality, during the early COVID-19 pandemic period (2020) compared with the pre-pandemic period (2019). Further research into the factors associated with increased mortality could help with preparedness in future pandemics.
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