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Background The impact of fibrinolysis-first strategy on outcomes of patients with ST-segment-elevation myocardial infarction (STEMI) during the COVID-19 pandemic was unknown. Methods Data from STEMI patients presenting to Fuwai Hospital from January 23 to April 30, 2020 were compared with those during the equivalent period in 2019. The primary end-point was net adverse clinical events (NACE; a composite of death, non-fatal myocardial reinfarction, stroke, emergency revascularization, and bleeding over BARC type 3). The secondary outcome was a composite of recurrent ischaemia, cardiogenic shock, and exacerbated heart failure. Results The final analysis included 164 acute STEMI patients from 2020 and 240 from 2019. Eighteen patients (20.2% of those with indications) received fibrinolysis therapy in 2020 with a median door-to-needle time of 60.0 (43.5, 92.0) minutes. Patients in 2020 underwent primary PCI less frequently than their counterparts (14 [14.2%] vs. 144 [86.8%] in 2019, P < 0.001), and had a longer median door-to-balloon time (175 [121,213] minutes vs. 115 [83, 160] minutes in 2019, P = 0.009). Patients were more likely to undergo elective PCI (86 [52.4%] vs. 28 [11.6%] in 2019, P < 0.001). The in-hospital NACE was similar between 2020 and 2019 (14 [8.5%] vs. 25 [10.4%], P = 0.530), while more patients developed a secondary outcome in 2020 (20 [12.2%] vs. 12 [5.0%] in 2019, P = 0.009). Conclusions The fibrinolysis-first strategy during the COVID-19 pandemic was associated with a lower rate of timely coronary reperfusion and increased rates of recurrent ischaemia, cardiogenic shock, and exacerbated heart failure. However, the in-hospital NACE remained similar to that in 2019.

Background Venous thromboembolism (VTE) is a multifactorial disease that is associated with long-term morbidity, dysfunction, and mortality. Although numerous studies have reported on the incidence and risk factors of VTE in hospitalized patients, the reported results vary due to the complexity of the disease and differences in genetic characteristics, social environment, and disease spectrum. Therefore, the aim of this study was to investigate the incidence, clinical features, and risk factors for VTE in hospitalized patients. Methods A cross-sectional study was conducted at Benxi Central Hospital to select patients hospitalized between January and December 2021. All patients underwent Doppler ultrasound, and medical data, including demographic characteristics, past medical history, comorbidities, and hematologic indicators, were collected from the Benxi Clinical Biobank. Chi-square tests and logistic regression analysis were employed to identify independent risk factors. Results A total of 1200 in-patients were eligible for inclusion in the study. The prevalence of venous thromboembolism was 21.4%. 224 patients developed DVT alone, 12 patients developed PE alone, and 14 patients developed both DVT and PE. Of the 238 patients with DVT in the lower limbs (with or without PE), distal DVT was more common than proximal DVT (64.7%vs20.2%). In multifactorial analysis, six variables are independent risk factors for VTE:Diabetes,OR,1.659,(1.100-2.501, P = 0.016);History of confirmedVTE,OR,6.497,(3.505–12.041,P = 0.000);Central venous catheterization,OR,2.605,(1.583–4.289,P = 0.000);Age,OR,1.035,(1.022–1.048,P = 0.000);HGB,OR,0.993,(0.987-1.000, P = 0.042);Unilateral limb pitting oedema,OR,5.307,(3.506–8.033, P = 0.000);Bilateral limb pitting oedema,OR,1.701,(1.081–2.676,P = 0.022). Conclusion The incidence of VTE among hospitalized patients in Benxi region is relatively high. Identifying relevant risk factors allows for early screening of at-risk populations. In order to reduce prevalence, and more prospective studies are needed to comprehensively develop individualised clinical prediction tools for VTE.