COVID-19 infected ST-Elevation myocardial infarction in India (COSTA INDIA)

Jabir, Abdullakutty; Geevar Zachariah,; Mohanan, Padinhare Purayil; Gupta, Mohit Dayal; Ramakrishnan, Sivasubramanian; Meena, Chandra Bhan; Sridhar, L.; Girish, Meennahalli Palleda; Das, Dipak Ranjan; Gupta, Anshul; Praveen Nagula,; Tom Devasia,; Bhavesh Vajifdar,; Kamlesh Thakkar,; Urmil Shah,; Tanuj Bhatia,; Smit Srivastava,; Sanjeev Sharma,; Priya Kubendiran,; Jayagopal, Pathiyil Balagopalan; Sudeep Kumar,; Deepthy Sadanandan,; Lincy Mathew,; Nitish Naik,; Anup Banerji,; Ashraf, S.M.; Asokan, P.K.; Bharti, Bishwa Bhushan; Majumder, Biswajit; Dhiman Kahali,; Sinha, Dhurjati Prasad; Sharma, Dipak; Dastidar, Dipankar Ghosh; Dipankar Mukhapdhyay,; Wander, Gurpreet Sing; Bali, Harinder Kumar; Kesavamoorthy, B.; Agarwala, Manoj Kumar; Khanna, Narendra Nath; Natesh, B.H.; Goel, Pravin K.; Chakraborty, Rabindra Nath; Jain, Rajendra Kumar; Rakesh Yadav,; Sameer Dani, L.; Satyavan Sharma,; Satyendra Tewari,; Sethi, K.K.; Sharad Chandra,; Mandal, Subrato; Bhandari, Suman; Sikdar, Sundandan; Vivek Gupta,; Rath, Pratap Chandra; Bang, Vijay Harikisan; Debabrata Roy,; Das, Mrinal Kanti; Banerjee, Partho Sarathi

doi:10.1016/j.ihj.2023.05.009

Cited by 2 publications

(1 citation statement)

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“… 35 36 All such data are available for high-income countries with limited data from lower-income countries such as India. 37 38 The present study shows that in the first year of the pandemic in India, there was a slight decline in COVID-19-related deaths suggesting a lack of access to healthcare for patients with ACS due to prolonged lockdowns. 39 40 The patients who reached the hospital were less sick resulting in slightly lower (though not significant) deaths following PCI.…”

Section: Discussionmentioning

confidence: 55%

Influence of COVID-19 pandemic in India on coronary artery disease clinical presentation, angiography, interventions and in-hospital outcomes: a single centre prospective registry-based observational study

Gupta,

Sharma,

Khedar

et al. 2024

BMJ Open

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ObjectiveThe study examined the influence of the COVID-19 pandemic in India on variation in clinical features, management and in-hospital outcomes in patients undergoing percutaneous coronary intervention (PCI).DesignProspective registry-based observational study.SettingA tertiary care hospital in India participant in the American College of Cardiology CathPCI Registry.Participants7089 successive patients who underwent PCI from April 2018 to March 2023 were enrolled (men 5627, women 1462). Details of risk factors, clinical presentation, coronary angiography, coronary interventions, clinical management and in-hospital outcomes were recorded. Annual data were classified into specific COVID-19 periods according to Government of India guidelines as pre-COVID-19 (April 2018 to March 2019, n=1563; April 2019 to March 2020, n=1594), COVID-19 (April 2020 to March 2020, n=1206; April 2021 to March 2022, n=1223) and post-COVID-19 (April 2022 to March 2023, n=1503).ResultsCompared with the patients in pre-COVID-19 and post-COVID-19 periods, during the first COVID-19 year, patients had more hypertension, non-ST elevation myocardial infarction (NSTEMI), lower left ventricular ejection fraction (LVEF) and multivessel coronary artery disease (CAD). In the second COVID-19 year, patients had more STEMI, lower LVEF, multivessel CAD, primary PCI, multiple stents and more vasopressor and mechanical support. There were 99 (1.4%) in-hospital deaths which in the successive years were 1.2%, 1.4%, 0.8%, 2.4% and 1.3%, respectively (p=0.019). Compared with the baseline year, deaths were slightly lower in the first COVID-19-year (age-sex adjusted OR 0.68, 95% CI 0.31 to 1.47) but significantly more in the second COVID-19-year (OR 1.97, 95% CI 1.10 to 3.54). This variation attenuated following adjustment for clinical presentation, extent of CAD, in-hospital treatment and duration of hospitalisation.ConclusionsIn-hospital mortality among patients with CAD undergoing PCI was significantly higher in the second year of the COVID-19 pandemic in India and could be one of the reasons for excess deaths in the country. These patients had more severe CAD, lower LVEF, and more vasopressor and mechanical support and duration of hospitalisation.

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Section: Discussionmentioning

confidence: 55%