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Changing pattern of admissions for acute myocardial infarction in India during the COVID-19 pandemic

Authors :
Geevar Zachariah
Sivasubramanian Ramakrishnan
Mrinal Kanti Das
Abdullakutty Jabir
Pathiyil Balagopalan Jayagopal
Krishnannair Venugopal
Kalaivani Mani
Amal Kumar Khan
Amit Malviya
Anshul Gupta
Ashok Goyal
B.P. Singh
Bishav Mohan
Bishwa Bhushan Bharti
Biswajit Majumder
Bivin Wilson
Chakkalakkal Prabhakaran Karunadas
Chandra Bhan Meena
Cholenahally Nanjappa Manjunath
Mathew Cibu
Debabrata Roy
Dinesh Choudhary
Dipak Ranjan Das
Dipak Sarma
Meennahalli Palleda Girish
Gurpreet Singh Wander
Harsh Wardhan
Janakiraman Ezhilan
Karthik Tummala
Virender Kumar Katyal
Kewal Goswami
Kodangala Subramanyam
Krishna Kishore Goyal
Kenchappa Kumar
Lekha Adik Pathak
Manish Bansal
Manoranjan Mandal
Mohit Dayal Gupta
Narendra Nath Khanna
Natesh Bangalore Hanumanthappa
Neil Bardoloi
Nitin Modi
Nitish Naik
Pradeep K. Hasija
Prafulla Kerkar
Pranab Jyoti Bhattacharyya
Pushkraj Gadkari
Rabindra Nath Chakraborthy
Rahul Raosaheb Patil
Rakesh Gupta
Rakesh Yadav
Rambhatla Suryanarayana Murty
Ranjit Kumar Nath
Rathinavel Sivakumar
Rishi Sethi
Rituparna Baruah
Sanjay Tyagi
Santanu Guha
Santhosh Krishnappa
Satish Kumar
Satya Narayan Routray
Satyendra Tewari
Saumitra Ray
Seemala Saikrishna Reddy
Sharad Chandra
Shashi Bhushan Gupta
Shashi Shekhar Chatterjee
K.K.H. Siddiqui
Maduramuthu Sivabalan
Sreekanth Yerram
Sudeep Kumar
Swaminathan Nagarajan
Tom Devasia
Uday Jadhav
Varun Shankar Narain
Vijay Kumar Garg
Vitull K. Gupta
Dorairaj Prabhakaran
Pradip Kumar Deb
Padinhare Purayil Mohanan
Source :
Indian Heart Journal, Vol 73, Iss 4, Pp 413-423 (2021)
Publication Year :
2021
Publisher :
Elsevier, 2021.

Abstract

Aim: Studies on the changes in the presentation and management of acute myocardial infarction (AMI) during the COVID-19 pandemic from low- and middle-income countries are limited. We sought to determine the changes in the number of admissions, management practices, and outcomes of AMI during the pandemic period in India. Methods & Results: In this two-timepoint cross-sectional study involving 187 hospitals across India, patients admitted with AMI between 15th March to 15th June in 2020 were compared with those admitted during the corresponding period of 2019.We included 41,832 consecutive adults with AMI. Admissions during the pandemic period (n = 16414) decreased by 35·4% as compared to the corresponding period in 2019 (n = 25418). We observed significant heterogeneity in this decline across India. The weekly average decrease in AMI admissions in 2020 correlated negatively with the number of COVID cases (r = −0·48; r2 = 0·2), but strongly correlated with the stringency of lockdown index (r = 0·95; r2 = 0·90). On a multi-level logistic regression, admissions were lower in 2020 with older age categories, tier 1 cities, and centers with high patient volume. Adjusted utilization rate of coronary angiography, and percutaneous coronary intervention decreased by 11·3%, and 5·9% respectively. Conclusions: The magnitude of reduction in AMI admissions across India was not uniform. The nature, time course, and the patient demographics were different compared to reports from other countries, suggesting a significant impact due to the lockdown. These findings have important implications in managing AMI during the pandemic.

Details

Language :
English
ISSN :
00194832
Volume :
73
Issue :
4
Database :
Directory of Open Access Journals
Journal :
Indian Heart Journal
Publication Type :
Academic Journal
Accession number :
edsdoj.bc0ed9d722479383a0548199fb8055
Document Type :
article
Full Text :
https://doi.org/10.1016/j.ihj.2021.06.003