OR44. Impact of the COVID-19 Pandemic on Admission of Acute Coronary Syndrome Patients: A Local Insight from iSTEMI Registry

Despite the spike in COVID-19 hospitalizations, the number of acute coronary syndrome (ACS) admissions has declined significantly. It raises concerns about the long-term consequences of cardiovascular problems. This study aims to provide new insights into our awareness of the pandemic situation in ACS settings.

We performed a single centre retrospective analysis of 397 patients from iSTEMI Registry between March-October 2019 (Pre-COVID-19 pandemic) and March-October 2020 (COVID-19 pandemic) with ACS (i.e., unstable angina (UA), non-ST-segment elevation myocardial infarction (NSTEMI), and STEMI). We analyzed case fatality rate, delay to First Medical Contact (FMC), and troponin findings.

The number of ACS patients admissions in March-October 2019 (254 patients) and 2020 (143 patients) had significantly reduced by 43.7%. Admission of ACS significantly dropped for STEMI (35.76%, p=0.048) and NSTEMI (65.70%, p=0.001), but not for UA (31.90%, p=0.262). There was non-significant case fatality rate between-group of STEMI (p = 0.168), NSTEMI (p = 0.388), or UA (p = 0.343). We found a significant delay to FMC during pandemic (39.8%, p=0.000) and correlated with the higher troponin I level (30,6%, p=0.001).

This study reveals that local conditions in our institution are similar to the other centers during the COVID-19 pandemic. In parallel to the COVID-19 burden, we will have to deal with the morbidity and mortality caused by delays in FMC and patients severity in the future. Further studies are needed to analyze the factors that decreased ACS patients' admission.