There are far fewer patients coming to hospitals with heart attacks during the COVID-19 pandemic as compared to averages prior to the pandemic. This has raised concerns that delayed treatment will cause an uptick in cardiac deaths and heart failure. Photo from Getty Images
April 28, 2021 – Results from a retrospective observational study, presented today at Society for Cardiovascular Angiography and Interventions (SCAI) 2021 Virtual Scientific Sessions, reveal a 70% decline in the number of patients presenting with acute myocardial infarction (AMI) during April 2020 compared to April 2019. While the number of patients with AMI seeking care at hospitals dropped during the pandemic, those that did receive care experienced more severe symptoms because of delays in patients seeking emergency services.
AMI, commonly recognized as a heart attack, is responsible for more than 1 million deaths in the U.S. every year. For the best patient outcomes, seeking care within the first 90 minutes of heart attack symptoms is critical and delaying care can lead to complications or increased mortality. This study also comes at a time when heart disease remains the No. 1 cause of death for Americans.
The single-center retrospective observational study was conducted at NYU Langone Health in New York City. Researchers compared patients with AMI who underwent invasive coronary angiography in April 2020 versus April 2019. The study was intended to compare characteristics and outcomes of patients with AMI during the peak of the pandemic.
Findings show there was a significant reduction in AMI cases referred for invasive angiography in April 2020 compared to April 2019. Of patients with AMI, a larger proportion (39%), had ST-elevation myocardial infarction (STEMI) than in April 2019 (20%). There was a trend toward delayed times between symptom onset and hospitalization in 2020. Investigators noted no differences in demographics, comorbidities or baseline medications before or after the pandemic. Multi-vessel coronary disease was less common, but peak troponin concentrations were higher in 2020 than in the previous year.
“We were surprised to observe a significant reduction in the number of patients referred for coronary management of MI; this suggests that many patients may have stayed at home despite their symptoms of a heart attack,” said Nina Talmor, M.D., lead investigator and internal medicine resident, NYU Langone Health. “Our findings point to the need for improved public health messaging for future health crises, so that people do not remain at home out of fear, rather than seeking necessary and potentially lifesaving care. We hope our study will bring awareness to the need for timely cardiac care both in and out of a pandemic.”
Study authors look to re-address public health messaging to direct patients to appropriately seek the best care for their condition for future health emergencies.
SCAI Surveys Confirm Patients Fear COVID More Than Heart Attacks and Stroke
SCAI has raised concern about the lower than usual numbers of heart attack patients showing up at emergency departments during the pandemic. The issue is not just in the U.S., but around the world, where patients are apprehensive about going to hospitals out of fear of contracting COVID.
SCAI sent two surveys to patients this past year to gauge perceptions and found fear of catching COVID-19 is seen as playing a role in preventing people from going to the hospital if they do have a heart attack or stroke, or even seeing their doctors for checkups or for cardiac complaints they might be having. This is leading to an increase in patients showing up very late after the onset of heart attacks, leading to serious cardiac damage and worse outcomes. This was a concern early on in the U.S. spread of the virus, but the most recent survey from the end of 2020 shows patients attitudes and fears have not improved much since last spring.
Learn more in the VIDEO: Patients Fear COVID More than Heart Attacks — Interview with SCI President Cindy Grines, M.D.
For more information: www.scai.org
Related STEMI COVID Content:
VIDEO: Where Have all the STEMI Cases Gone Amid COVID-19? — Interview with Thomas Maddox, M.D.
2. Centers for Disease Control and Prevention. Underlying Cause of Death, 1999–2018. CDC WONDER Online Database. Atlanta, GA: Centers for Disease Control and Prevention; 2018. Accessed March 12, 2020.