Table 1.
Characteristics, time delays, and in-hospital outcomes in patients with acute myocardial infarction admitted within the first 48 hours of symptom onset during the pandemic and pre-pandemic periods
| Characteristics | TURKMI-1 (Pre-pandemic registry) | TURKMI-2 (Pandemic registry) | P-All | P-NSTEMI | P-STEMI | ||||
|---|---|---|---|---|---|---|---|---|---|
| All (n=1872) | NSTEMI (n=1161) | STEMI (n=711) | All (n=991) | NSTEMI (n=506) | STEMI (n=485) | ||||
| Age, years | 62 (53-71) | 63 (54-72) | 60 (51-70) | 60 (51-69) | 61 (52-71) | 58 (49-66) | <0.001 | 0.050 | 0.012 |
| Age, years | 62 (13) | 63 (13) | 60 (14) | 60 (13) | 62 (12) | 59 (13) | |||
| Female | 492 (26.3) | 333 (28.7) | 159 (22.4) | 236 (23.8) | 138 (27.3) | 98 (20.2) | 0.149 | 0.557 | 0.373 |
| Hypertension (self-reported) | 922 (49.3) | 649 (55.9) | 273 (38.4) | 499 (50.4) | 278 (54.9) | 221 (45.6) | 0.575 | 0.717 | 0.013 |
| Diabetes | 633 (33.8) | 432 (37.2) | 201 (28.3) | 335 (33.8) | 184 (36.4) | 151 (31.1) | 0.996 | 0.742 | 0.286 |
| Smoking | 914 (48.8) | 513 (44.2) | 401 (56.4) | 432 (43.6) | 184 (36.4) | 248 (51.1) | 0.008 | 0.003 | 0.073 |
| Hypercholesterolemia (self-reported) | 215 (11.5) | 148 (12.7) | 67 (9.4) | 256 (25.8) | 148 (29.2) | 108 (22.3) | <0.001 | <0.001 | <0.001 |
| History of coronary artery disease | 528 (28.2) | 406 (35) | 122 (17.2) | 283 (28.7) | 190 (37.8) | 93 (19.3) | 0.767 | 0.273 | 0.346 |
| Infarct localization | |||||||||
| Anterior | - | - | 340 (48.1) | - | - | 238 (49.1) | - | - | 0.739 |
| Inferior (±posterior) | - | - | 367 (51.9) | - | - | 247 (50.9) | |||
| Mode of Admission to hospital (study center) | |||||||||
| By Ambulance | 213 (11.7) | 88 (7.8) | 125 (17.9) | 205 (20.7) | 77 (15.2) | 128 (26.4) | <0.001 | <0.001 | <0.001 |
| Transfer from a non-PCI-capable hospital | 694 (38.1) | 419 (37.3) | 275 (39.3) | 391 (39.5) | 185 (36.6) | 206 (42.5) | 0.477 | 0.772 | 0.281 |
| Self-transport | 915 (50.2) | 616 (54.9) | 299 (42.8) | 395 (39.9) | 244 (48.2) | 151 (31.1) | <0.001 | .0013 | <0.001 |
| Mode of admission to study center for those | |||||||||
| transferred from a non-PCI-capable center | |||||||||
| By Ambulance | - | - | - | 131 (34) | 59 (32.6) | 72 (35.3) | - | - | - |
| Self-transport | - | - | - | 254 (66) | 122 (67.4) | 132 (64.7) | |||
| Time delays | |||||||||
| Symptom-onset to EMS call, min | 52.5 (15-170) | 67.5 (15-290) | 32.5 (15-120) | 90 (30-240) | 125 (30-315) | 80 (30-195) | 0.001 | 0.080 | 0.003 |
| EMS call to EMS arrival, min | 15 (10-20) | 15 (10-20) | 15 (10-20) | 15 (10-20) | 15 (10-20) | 15 (15-20) | <0.001 | 0.103 | <0.001 |
| Time delay for those transferred from a | 169 (99-300) | 235.5 (120-390) | 120 (63-180) | 180 (90-296) | 265 (135-390) | 120 (60-186.5) | 0.691 | 0.084 | 0.710 |
| non-PCI-capable hospital, min | |||||||||
| Symptom-onset to hospital (study center) arrival, min | 215.5 (90-473) | 295 (120-582.5) | 150 (70-300) | 270 (120-630) | 419 (180-840) | 185 (100-360) | <0.001 | <0.001 | <0.001 |
| Transferred from a non-PCI-capable center | 332 (180-635) | 424 (260-763) | 240 (145-365) | 390 (210-690) | 512 (360-930) | 240 (167-453) | 0.036 | <0.001 | 0.125 |
| Directly admitted to the study center | 135 (60-370) | 180 (74-450) | 100 (56-240) | 181 (90-550) | 275 (120-785) | 145 (70-303) | <0.001 | <0.001 | <0.001 |
| (by EMS or self-transport) | |||||||||
| In-hospital procedures and times | |||||||||
| Coronary angiography | 1758 (93.9) | 1054 (90.8) | 704 (99) | 871 (87.9) | 396 (78.3) | 475 (97.9) | <0.001 | <0.001 | 0.122 |
| Fibrinolytic therapy | - | - | 13 (1.8) | - | - | 11 (2.3) | - | - | 0.594 |
| PCI | 1374 (73.4) | 700 (60.3) | 674 (94.8) | 682 (68.8) | 240 (47.4) | 442 (91.1) | 0.010 | <0.001 | 0.013 |
| Door-to-needle time, min | 30 (15-60) | ||||||||
| Door-to-balloon time, min | - | - | 37 (25-65) | - | - | 40 (25-68) | - | - | 0.448 |
| Total ischemic time, min | - | - | 195 (115-331) | - | - | 245 (149-469) | - | - | <0.001 |
| Time from arrival to study center to | - | 1050 (300-2095) | - | - | 501.5 (134-1225) | - | - | <0.001 | - |
| Coronary angiography for NSTEMIs | |||||||||
| In-hospital outcomes | |||||||||
| MACE (death, heart failure, or cardiogenic shock) | 90 (4.8) | 40 (3.4) | 50 (7.0) | 88 (8.9) | 30 (5.9) | 58 (12.0) | <0.001 | 0.020 | 0.004 |
| Death | 71 (3.8) | 33 (2.8) | 38 (5.3) | 31 (3.1) | 8 (1.6) | 23 (4.7) | 0.361 | 0.126 | 0.642 |
| Heart failure or cardiogenic shock | 53 (2.8) | 23 (2) | 30 (4.2) | 82 (8.3) | 28 (5.5) | 54 (11.1) | <0.001 | <0.001 | <0.001 |
Data were expressed as mean (SD), median (interquartile range), or n (%). EMS - emergency medical service call; MACE - major adverse cardiac events; MI - myocardial infarction; NSTEMI - non-ST elevation MI; PCI - percutaneous coronary intervention; STEMI - ST elevation MI