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. 2021 Jun 15;11(3):295-299.
eCollection 2021.

The bimodal "rise and fall" ACS curve overlapping COVID-19 pandemic peaks

Daniela Trabattoni  1 , Paolo M Ravagnani  1 , Luca Merlino  1 , Piero Montorsi  1   2 , Antonio L Bartorelli  1   3
Affiliations

The bimodal "rise and fall" ACS curve overlapping COVID-19 pandemic peaks

Daniela Trabattoni et al. Am J Cardiovasc Dis. .

Abstract

Background: The COVID-19 outbreak harmed acute coronary syndromes. During the national lockdown in Italy, the fear of post-admission contagion translated into significant delays in seeking medical help among STEMI (ST-elevation myocardial infarction) patients.

Objective and methods: Our analysis aimed to assess the ACS (Acute Coronary Syndromes) admissions during the pandemic, together with time to presentation and clinical outcomes compared to 2019 in a cardiovascular hub in Milan. Data of ACS patients admitted during the pandemic year 2020 were extracted by the hospital's database and compared to a historical cohort of patients admitted for the same clinical indications in 2019.

Results: A total of 599 ACS cases were recorded in 2020 vs. 386 cases in 2019, with a net 55% increase, associated with late clinical presentations, a threefold increase in cardiogenic shock, and a more than two-fold higher mortality rate.

Conclusions: The ultimate goal of this analysis is to preserve the life-saving focus on universal and prompt STEMI diagnosis and treatment, even in a time of dynamic global crisis.

Keywords: ACS; COVID-19 outbreak; STEMI; late presentation.

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Conflict of interest statement

None.

Figures

Figure 1
Figure 1
Cumulative increase in emergency (+32%) and urgency (+67%) interventional coronary procedures performed during Covid-19 pandemic outbreaks in 2020 compared to same periods in 2019.
Figure 2
Figure 2
ACS increase in 2020 reached the highest point with a bimodal presentation, paralleling the most contagious outbreak periods (arrows).
See this image and copyright information in PMC

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