1
|
Zachariah G, Ramakrishnan S, Das MK, Jabir A, Jayagopal PB, Venugopal K, Mani K, Khan AK, Malviya A, Gupta A, Goyal A, Singh BP, Mohan B, Bharti BB, Majumder B, Wilson B, Karunadas CP, Meena CB, Manjunath CN, Cibu M, Roy D, Choudhary D, Das DR, Sarma D, Girish MP, Wander GS, Wardhan H, Ezhilan J, Tummala K, Katyal VK, Goswami K, Subramanyam K, Goyal KK, Kumar K, Pathak LA, Bansal M, Mandal M, Gupta MD, Khanna NN, Hanumanthappa NB, Bardoloi N, Modi N, Naik N, Hasija PK, Kerkar P, Bhattacharyya PJ, Gadkari P, Chakraborthy RN, Patil RR, Gupta R, Yadav R, Murty RS, Nath RK, Sivakumar R, Sethi R, Baruah R, Tyagi S, Guha S, Krishnappa S, Kumar S, Routray SN, Tewari S, Ray S, Reddy SS, Chandra S, Gupta SB, Chatterjee SS, Siddiqui KKH, Sivabalan M, Yerram S, Kumar S, Nagarajan S, Devasia T, Jadhav U, Narain VS, Garg VK, Gupta VK, Prabhakaran D, Deb PK, Mohanan PP. Changing pattern of admissions for acute myocardial infarction in India during the COVID-19 pandemic. Indian Heart J 2021; 73:413-423. [PMID: 34474751 PMCID: PMC8424286 DOI: 10.1016/j.ihj.2021.06.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 06/08/2021] [Accepted: 06/09/2021] [Indexed: 02/07/2023] Open
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.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Kalaivani Mani
- Dept. of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | | | - Amit Malviya
- Department of Cardiology, North Eastern Indira Gandhi Regional Institute of Health & Medical Sciences, Shillong, Meghalaya, India
| | | | | | - B P Singh
- Department of Cardiology, Indra Gandhi Institute of Medical Sciences, Patna, India
| | | | | | | | | | | | | | | | | | - Debabrata Roy
- Rabindranath Tagore International Institute of Cardiac Sciences, Kolkata, India
| | | | | | - Dipak Sarma
- Christian Medical Centre Hospital, Jorhat, India
| | | | | | - Harsh Wardhan
- Mahatma Gandhi Medical College and Hospital, Jaipur, India
| | | | | | - Virender Kumar Katyal
- Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India
| | - Kewal Goswami
- All India Institute of Medical Sciences, New Delhi, India
| | | | | | | | | | | | - Manoranjan Mandal
- Department of Cardiology, Nil Ratan Sircar Medical College, Kolkata, India
| | | | | | | | | | | | - Nitish Naik
- All India Institute of Medical Sciences, New Delhi, India
| | | | | | | | | | | | | | | | - Rakesh Yadav
- All India Institute of Medical Sciences, New Delhi, India
| | | | | | | | - Rishi Sethi
- King George Medical University, Lucknow, India
| | | | - Sanjay Tyagi
- Department of Cardiology, GB Pant Hospital, New Delhi, India
| | | | - Santhosh Krishnappa
- Cardiology Department, Sri Jayadeva Institute of Cardiovascular Science and Research, Mysore, India
| | | | - Satya Narayan Routray
- Department of Cardiology, Srirama Chandra Bhanja Medical College and Hospital, Odissa, India
| | - Satyendra Tewari
- Department of Cardiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Saumitra Ray
- Vivekananda Institute of Medical Sciences, Kolkata, India
| | | | | | | | | | | | | | - Sreekanth Yerram
- Department of Cardiology, Nizam's Institute of Medical Science, Hyderabad, India
| | - Sudeep Kumar
- Department of Cardiology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | | | | | - Uday Jadhav
- Consultant in Cardiology Department, MGM New Bombay Hospital, Mumbai, India
| | | | | | | | | | | | | |
Collapse
|