دورية أكاديمية
أعرض في EDS

Comparative Trends in Ischemic Heart Disease Admissions, Presentation and Outcomes Due to the COVID-19 Pandemic: First Insights From a Tertiary Medical Center in Pakistan.

التفاصيل البيبلوغرافية
العنوان: Comparative Trends in Ischemic Heart Disease Admissions, Presentation and Outcomes Due to the COVID-19 Pandemic: First Insights From a Tertiary Medical Center in Pakistan.
المؤلفون: Noorali AAA; Medicine, Aga Khan University, Karachi, PAK., Thobani H; Cardiothoracic Surgery, Aga Khan University, Karachi, PAK., Hashmi S; Cardiothoracic Surgery, Aga Khan University, Karachi, PAK., Iqbal S; Cardiothoracic Surgery, Aga Khan University, Karachi, PAK., Merchant AA; Cardiothoracic Surgery, Aga Khan University, Karachi, PAK., Haroon MA; Cardiothoracic Surgery, Aga Khan University, Karachi, PAK., Chauhan SSB; Education, Center for Innovation in Medical Education, Aga Khan University, Karachi, PAK., Mallick S; Medicine, Aga Khan University, Karachi, PAK., Zahid N; Cardiothoracic Surgery, Aga Khan University, Karachi, PAK., Khan Y; Cardiothoracic Surgery, Aga Khan University, Karachi, PAK., Faheem O; Cardiology, Aga Khan University, Karachi, PAK., Fatimi SH; Cardiothoracic Surgery, Aga Khan University, Karachi, PAK.
المصدر: Cureus [Cureus] 2021 Aug 30; Vol. 13 (8), pp. e17558. Date of Electronic Publication: 2021 Aug 30 (Print Publication: 2021).
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Cureus, Inc Country of Publication: United States NLM ID: 101596737 Publication Model: eCollection Cited Medium: Print ISSN: 2168-8184 (Print) Linking ISSN: 21688184 NLM ISO Abbreviation: Cureus Subsets: PubMed not MEDLINE
أسماء مطبوعة: Original Publication: Palo Alto, CA : Cureus, Inc.
مستخلص: Introduction COVID-19 has manifested a striking disarray in healthcare access and provision, particularly amongst patients presenting with life-threatening ischemic heart disease (IHD). The paucity of data from low-middle income countries has limited our understanding of the consequential burden in the developing world. We aim to compare volumes, presentations, management strategies, and outcomes of IHD amongst patients presenting in the same calendar months before and during the COVID-19 pandemic. Methods We conducted a retrospective cross-sectional analysis at the Aga Khan University Hospital, one of the premier tertiary care centres in Pakistan. Data were collected on all adult patients (>18 years) who were admitted with IHD (acute coronary syndrome (ACS) and stable angina) from March 1 to June 30, 2019 (pre-COVID) and March 1 to June 30, 2020 (during-COVID), respectively. Group differences for continuous variables were evaluated using student t-test or Mann-Whitney U test. The chi-squared test or Fisher test was used for categorical variables. Values of p less than 0.05 were considered statistically significant. P-value trend calculation and graphical visualization were done using STATA (StataCorp, College Station, TX). Results Data were assimilated on 1019 patients, with 706 (69.3%) and 313 (30.7%) patients presenting in each respective group (pre-COVID and during-COVID). Current smoking status (p=0.019), admission source (p<0.001), month of admission (p<0.001), proportions ACS (p<0.001), non-ST-elevation-myocardial-infarction (NSTEMI; p<0.001), unstable angina (p=0.025) and medical management (p=0.002) showed significant differences between the two groups, with a sharp decline in the during-COVID group. Monthly trend analysis of ACS patients showed the most significant differences in admissions (p=0.001), geographic region (intra-district vs intracity vs outside city) (p<0.001), time of admission (p=0.038), NSTEMI (p=0.002) and medical management (p=0.001). Conclusion These data showcase stark declines in ACS admissions, diagnostic procedures (angiography) and revascularization interventions (angioplasty and coronary artery bypass graft surgery, CABG) in a developing country where resources and research are already inadequate. This study paves the way for further investigations downstream on the short- and long-term consequences of untreated IHD and reluctance in health-seeking behaviour.
Competing Interests: The authors have declared that no competing interests exist.
(Copyright © 2021, Noorali et al.)
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فهرسة مساهمة: Keywords: acute coronary syndrome; coronary artery disease; covid-19; developing countries; myocardial ischemia
تواريخ الأحداث: Date Created: 20211014 Latest Revision: 20211015
رمز التحديث: 20221213
مُعرف محوري في PubMed: PMC8480226
DOI: 10.7759/cureus.17558
PMID: 34646615
قاعدة البيانات: MEDLINE
الوصف
تدمد:2168-8184
DOI:10.7759/cureus.17558