Klinische und prozedurale Charakteristika von Patienten mit akutem Koronarsyndrom während der COVID-19-Pandemie 2020 im Vergleich zu einer Kontrollgruppe aus 2019

 

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Zusammenfassung

Hintergrund Während der COVID-19-Pandemie wurden ärztliche Behandlungen abgesagt und notfallmäßige Behandlungen aus Angst vor einer Ansteckung mit Sars-CoV-2 hinausgezögert. Letzteres betraf auch Patienten mit akutem Koronarsyndrom. Eine detaillierte Beschreibung dieser Patienten in Bezug auf das Management im Herzkatheterlabor ist bislang aber noch nicht erfolgt.

Methoden Retrospektive Querschnittsstudie mit Erfassung aller Patienten, die wegen eines akuten Koronarsyndroms (STEMI, NSTEMI, instabile Angina) einer Herzkatheteruntersuchung vom 01.03.2019–30.06.2019 (Gruppe A) sowie vom 01.03.2020–30.06.2020 (Gruppe B) unterzogen wurden. Demografische Faktoren, kardiovaskuläre Risikofaktoren sowie prozedurale Daten (z.B. Ausmaß der KHK, klinische Diagnose, Revaskularisationsstrategie und -ergebnis, Einsatz eines Herzunterstützungssystems, Door-to-Needle-Time, In-hospital-Mortalität) wurden verglichen.

Ergebnisse 469 Patienten wurden in die Studie eingeschlossen (Gruppe A 239, Gruppe B 230 Patienten, mittleres Alter 69 Jahre, 71% männlich). Verglichen mit Gruppe A zeigten sich bei Gruppe B weniger Patienten mit STEMI und instabiler Angina pectoris (p=0,033), dafür mehr Patienten mit NSTEMI (p=0,047). Patienten in der Gruppe B hatten seltener eine koronare Eingefäßerkrankung (p=0,001), dafür wiesen diese häufiger eine koronare Dreigefäßerkrankung als in der Gruppe A auf (p=0,052).

Schlussfolgerung Trotz vergleichbarer Gesamtzahlen wurden Patienten mit akutem Koronarsyndrom während der COVID-19-Pandemie im Vergleich zu einer Kontrollgruppe häufiger mit NSTEMI aufgenommen und hatten ein größeres Ausmaß der KHK.

Abstract

Background During the COVID-19 pandemic medical treatments including emergencies were often delayed, in part because of fear of an infection with Sars-CoV-2. Even patients with an acute coronary syndrome (ACS) were affected by these circumstances. In the present study we provide a systematic comparison of patients with ACS during the COVID-19 pandemic compared to a control group.

Methods This is a retrospective cross-sectional study including all patients admitted with an ACS (STEMI, NSTEMI, unstable angina) undergoing coronary angiography between March 2019 and June 2019 (group A) and between March 2020 and June 2020 (group B). Demographic factors, cardiovascular risk factors and procedural data (extent of coronary disease, clinical diagnose, revascularisation strategy and outcome, use of mechanical support devices, door-to-needle time and in-hospital mortality) were compared.

Results 469 patients were included in the present study (239 patients in group A and 230 in group B, mean age 69 years, 71% male). Compared to group A there were fewer patients with STEMI and unstable angina (p=0,033) but more patients with NSTEMI (p=0,047) in group B. Patients in group B had less often single vessel disease (p=0,001) but in contrast more often triple vessel disease compared to group A (p=0,052).

Conclusion Despite overall comparable numbers of ACS patients those admitted during the COVID-19 pandemic were more frequently diagnosed with NSTEMI and had a larger extent of coronary disease compared to a control group.

Publication History

Received: 24 September 2021

Accepted after revision: 19 October 2022

Article published online:
05 December 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

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