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Is the Revascularization Strategy and Outcome Different in Patients with Acute Coronary Syndrome in COVID -19 pandemic Era:A tertiary centre experience
  • +11
  • ibrahim aktürk,
  • Dilay Karabulut,
  • Ersan Oflar,
  • sait ertığrul,
  • veli polat,
  • alparslan şahin,
  • feridun koşar,
  • ibrahim halil bayrak,
  • atilla koyuncu,
  • ilayda bostancı,
  • fahrettin katkat,
  • aysun karahan,
  • Kudret Keskin,
  • nihan çağlar
ibrahim aktürk
Istanbul Bakirkoy Dr Sadi Konuk Egitim ve Arastirma Hastanesi

Corresponding Author:[email protected]

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Dilay Karabulut
Istanbul Bakirkoy Dr Sadi Konuk Training and Research Hospital
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Ersan Oflar
Istanbul Bakirkoy Dr Sadi Konuk Training and Research Hospital
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sait ertığrul
Istanbul Bakirkoy Dr Sadi Konuk Egitim ve Arastirma Hastanesi
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veli polat
Istanbul Bakirkoy Dr Sadi Konuk Egitim ve Arastirma Hastanesi
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alparslan şahin
Istanbul Bakirkoy Dr Sadi Konuk Egitim ve Arastirma Hastanesi
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feridun koşar
Istanbul Bakirkoy Dr Sadi Konuk Egitim ve Arastirma Hastanesi
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ibrahim halil bayrak
Istanbul Bakirkoy Dr Sadi Konuk Egitim ve Arastirma Hastanesi
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atilla koyuncu
Istanbul Bakirkoy Dr Sadi Konuk Egitim ve Arastirma Hastanesi
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ilayda bostancı
Istanbul Bakirkoy Dr Sadi Konuk Egitim ve Arastirma Hastanesi
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fahrettin katkat
Istanbul Bagcilar Training and Research Hospital
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aysun karahan
Istanbul Bakirkoy Dr Sadi Konuk Egitim ve Arastirma Hastanesi
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Kudret Keskin
Sisli Hamidiye Etfal Training and Research Hospital
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nihan çağlar
Istanbul Bakirkoy Dr Sadi Konuk Egitim ve Arastirma Hastanesi
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Abstract

Objectives: Coronavirus disease of 2019 (COVID 19) became a major public health issue, causing millions of deaths world wide. The burden of COVID 19 pandemics on access to medical care and the treatment of patients with chronic diseases and acute coronary syndromes (ACS) is not fully determined yet. . Methods: A total of 239 patients with ACS were enrolled into the study. Patients were divided into two groups. First group was prepandemic group consisted of patients admitted at January and February 2020, before the pandemic. Second group was consisted of ACS patients admitted through April and May 2020 during pandemic. Both groups were compared according to demographic properties, blood chemistry findings, angiographic features, revascularisation strategies and clinical outcomes. Results: During pandemic period we observed an increase in total number of patient with ST elevation miyocardial infarction (STEMI) patients compared to prepandemic period ( 59(45%) vs 32 (29.6%) respectively). Initial high sensitive troponin and CK-MB levels were statistically higher in the pandemic group patients(1953 pg/ml vs 259 pg/ml for troponın I and 14 ng/ml vs 6ng/ml for CK-MB p<0.0001, p=0.02 respectively). TYPE 4a myocardial infarction due to stent thrombosis was more frequent in pandemic group relative top re-pandemic group (10 vs 0 p=0.003). Post procedural TIMI flow grade was lower in pandemic group and distal embolization and TIMI thrombus score were significantly higher in the pandemic group compared top re-pandemic group (, p=0.001, p=0.02 ,p=0.002 respectively). However; there was no statistically significant difference in hospital mortality and short –term all cause mortality, among groups (p>0.05). Conclusion: We observed that although clinical, laboratory, and angiographic features were worse in ACS patients admitted during the pandemic compared to pre-pandemic period, the mortality rate of ACS was similar. It is important to keep coronary care units open and fully-functioning during the pandemic.