Health care quality and changes in the clinical characteristics of patients with nonST elevation acute coronary syndrome in a regional vascular center during the COVID19 pandemic

Abstract

Aim. To perform a comparative assessment of the clinical and demographic characteristics of patients with nonST elevation acute coronary syndrome (NSTEACS) and health care quality during the coronavirus disease 2019 (COVID19) pandemic. Material and methods. Data obtained from medical records were used. Statistical processing was performed using the Statistica 10.0 software package. The analysis included patients with NSTEACS treated in 2020 (n=524) and 2019 (n=395). The group for further analysis consisted of patients with nonST elevation myocardial infarction treated in 2020 (n=233) compared to 2019 (n=221). Results. An increase in the relative number of patients with unstable angina in the NSTEACS group was revealed. COVID19 was verified in 5,5% of patients with NSTEACS. Of these, pneumonia was diagnosed in 10 (34,5%) patients, while 11 (37,9%) patients were transferred to pulmonary hospitals. The remaining 18 (62,1%) patients were discharged for outpatient treatment. Infected patients had a higher risk of inhospital mortality according to the Global Registry of Acute Coronary Events (GRACE) score relative to general cohort of patients - 2,0 (1,0; 9,0) vs 1,0 (0,8; 3,0) (p=0,04). In addition, 215 (92,3%) patients underwent invasive coronary angiography, which is higher than in 2019 (78,7%) (p<0,001). An increase in revascularization prevalence in patients ≥75 years old was found (p=0,01). Conclusion. COVID19 pandemic has led to a change in the clinical characteristics of patients, while not having a significant impact on the scope of endovascular interventions and health care quality for patients with NSTEACS in the emergency cardiology department.