TY - JOUR
T1 - Changing pattern of admissions for acute myocardial infarction in India during the COVID-19 pandemic
AU - For the CSI-AMI Study group
AU - Zachariah, Geevar
AU - Ramakrishnan, Sivasubramanian
AU - Das, Mrinal Kanti
AU - Jabir, Abdullakutty
AU - Jayagopal, Pathiyil Balagopalan
AU - Venugopal, Krishnannair
AU - Mani, Kalaivani
AU - Khan, Amal Kumar
AU - Malviya, Amit
AU - Gupta, Anshul
AU - Goyal, Ashok
AU - Singh, B. P.
AU - Mohan, Bishav
AU - Bharti, Bishwa Bhushan
AU - Majumder, Biswajit
AU - Wilson, Bivin
AU - Karunadas, Chakkalakkal Prabhakaran
AU - Meena, Chandra Bhan
AU - Manjunath, Cholenahally Nanjappa
AU - Cibu, Mathew
AU - Roy, Debabrata
AU - Choudhary, Dinesh
AU - Das, Dipak Ranjan
AU - Sarma, Dipak
AU - Girish, Meennahalli Palleda
AU - Wander, Gurpreet Singh
AU - Wardhan, Harsh
AU - Ezhilan, Janakiraman
AU - Tummala, Karthik
AU - Katyal, Virender Kumar
AU - Goswami, Kewal
AU - Subramanyam, Kodangala
AU - Goyal, Krishna Kishore
AU - Kumar, Kenchappa
AU - Pathak, Lekha Adik
AU - Bansal, Manish
AU - Mandal, Manoranjan
AU - Gupta, Mohit Dayal
AU - Khanna, Narendra Nath
AU - Hanumanthappa, Natesh Bangalore
AU - Bardoloi, Neil
AU - Modi, Nitin
AU - Naik, Nitish
AU - Hasija, Pradeep K.
AU - Kerkar, Prafulla
AU - Bhattacharyya, Pranab Jyoti
AU - Gadkari, Pushkraj
AU - Chakraborthy, Rabindra Nath
AU - Patil, Rahul Raosaheb
AU - Devasia, Tom
N1 - Funding Information:
The work was supported by funds from Cardiological Society of India (CSI) and the participating chapters of CSI.
Publisher Copyright:
© 2021 Cardiological Society of India
PY - 2021/7/1
Y1 - 2021/7/1
N2 - 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.
AB - 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.
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U2 - 10.1016/j.ihj.2021.06.003
DO - 10.1016/j.ihj.2021.06.003
M3 - Article
AN - SCOPUS:85108976841
SN - 0019-4832
VL - 73
SP - 413
EP - 423
JO - Indian Heart Journal
JF - Indian Heart Journal
IS - 4
ER -