Regional differences in characteristics of patients with acute coronary syndromes pre- and during Coronavirus-2019 pandemic.
American heart journal plus · 2025-10-14 · Observational study
Abstract
INTRODUCTION: Coronavirus-2019 (COVID-19) pandemic placed unprecedented levels of stress on healthcare systems leading to prolonged waiting times and reduced access to emergency medical services. With acute coronary syndrome (ACS) longer delays could mean worsening of the symptoms of admitted patients. Studies exploring ACS in COVID-19 reported either results from one hospital or nation-wide registries and many of them did not report laboratory values. Aim of our study was to compare differences in patients and procedural characteristics before and during COVID-19 period in two hospitals differing mainly in population characteristics. METHODS: Data was gathered in two polish cities - Krakow (2nd biggest city in Poland) and Krosno (smaller city with big rural areas). We have analyzed years 2019 and 2020 and included 448 patients in Krosno and 678 patients in Krakow. RESULTS: In Krosno during pandemic patients were significantly more often transported from home by emergency medical services as opposed to period before COVID-19 (16.3 % vs. 62.2 %). Killip class at admission in Krosno was higher during pandemic (3.5 % vs. 10.4 % for Killip class 4). Similarly, patients in Krosno in 2020 had significantly higher troponin and NT-proBNP levels. We did not observe any of those differences in Krakow. Procedural characteristics were comparable in both interventional cardiology centers. CONCLUSIONS: Even among the same country large differences in health condition of patients with ACS may be observed between different areas. Those results highlight the need of regional protocols on how to improve patient related factors and accessibility to healthcare system during unprecedented events.