Korean Circulation Journal

The Korean Society of Cardiology (대한심장학회)
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Trends and Outcomes of Acute Myocardial Infarction During the Early COVID-19 Pandemic in the United States: A National Inpatient Sample Study

  • Harshith Thyagaturu (Department of Cardiology, West Virginia University) ;
  • Harigopal Sandhyavenu (Department of Internal Medicine, Weiss Memorial Hospital) ;
  • Anoop Titus (Department of Internal Medicine, Saint Vincent Hospital) ;
  • Nicholas Roma (Department of Internal Medicine, St. Luke's University Hospital Network) ;
  • Karthik Gonuguntla (Department of Cardiology, West Virginia University) ;
  • Neel Navinkumar Patel (Department of Internal Medicine, New York Medical College/Landmark Medical Center) ;
  • Anas Hashem (Department of Internal Medicine, Rochester General Hospital) ;
  • Jinnette Dawn Abbott (Department of Medicine, Division of Cardiology, Alpert Medical School of Brown University) ;
  • Sudarshan Balla (Department of Cardiology, West Virginia University) ;
  • Deepak L. Bhatt (Mount Sinai Heart, Icahn School of Medicine at Mount Sinai Health System)
  • Received : 2024.01.17
  • Accepted : 2024.06.04
  • Published : 2024.11.01
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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 pre-pandemic 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 in-hospital 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.

Keywords

Acknowledgement

The authors thank Elia Ben-Ari, Ph.D., of Arlington, Virginia, USA, who works with West Virginia Clinical and Translational Science Institute (WVCTSI) for the editorial support.

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