RESUMO
BACKGROUND: COVID-19 pandemic has affected around 20million patients worldwide and 2.0 million cases from India. The lockdown was employed to delay the pandemic. However, it had an unintentional impact on acute cardiovascular care, especially acute myocardial infarction (AMI). Observational studies have shown a decrease in hospital admissions for AMI in several developed countries during the pandemic period. We aimed to evaluate the impact of COVID-19 on the AMI admissions patterns across India. METHODS: In this multicentric, retrospective, cross-sectional study, we included all AMI cases admitted to participating hospitals during the study period 15th March to 15th June 2020 and compared them using a historical control of all cases of AMI admitted during the corresponding period in the year 2019. Major objective of the study is to analyze the changes inthe number of hospital admissions for AMI in hospitals across India. In addition, we intend to evaluate the impact of COVID-19 on the weekly AMI admission rates, and other performance measures like rates of thrombolysis/primary percutaneous interventions (PCI), window period, door to balloon time, and door to needle time. Other objectives include evaluation of changes in the major complications and mortality rates of AMI and its predictors during COVID-19 pandemic. CONCLUSIONS: This CSI-AMI study will provide scientific evidence about the impact of COVID-19 on AMI care in India. Based on this study, we may be able to suggest appropriate changes to the existing MI guidelines and to educate the public regarding emergency care for AMI during COVID-19 pandemic.
Assuntos
COVID-19/epidemiologia , Cardiologia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Infarto do Miocárdio/epidemiologia , Pandemias , Admissão do Paciente/tendências , Sociedades Médicas , Adulto , Comorbidade , Estudos Transversais , Feminino , Humanos , Incidência , Índia/epidemiologia , Masculino , Infarto do Miocárdio/terapia , Estudos Retrospectivos , SARS-CoV-2RESUMO
We conducted a hospital-based case-control investigation (150 cases and 176 controls) to examine the putative role of conventional risk factors in subjects with and without coronary heart disease from Eastern India. Multivariate binary logistic regression revealed the following as significant risk factors for coronary heart disease: male sex (OR = 4.6, p = 0.001), elevated total cholesterol/high-density lipoprotein ratio (OR = 4.0, p = 0.001), systolic blood pressure (OR = 3.0, p = 0.004), diastolic blood pressure (OR = 3.6, p = 0.002), fasting plasma glucose (OR = 3.0, p = 0.05), post-pondrial plasma glucose (OR = 3.2, p = 0.005), Impaired fasting glucose (OR = 3.7, p = 0.002), elevated triglyceride (OR = 3.1, p = 0.018), increased total cholesterol (OR = 3.0, p = 0.029), low-density lipoprotein (OR = 3.1, p = 0.001), low-density lipoprotein/high-density lipoprotein ratio (OR = 3.4, p = 0.004), central obesity (OR = 3.0, p = 0.006), smoking (OR = 3.7, p = 0.001) and urban residence (OR = 3.1, p = 0.003). In this study, the discriminant analysis showed that 77.2% of all entry for cases and 72.6% of all entry for controls were correctly classified using conventional risk factors and warrant early intervention for conventional risk factors.
Assuntos
Doença das Coronárias/epidemiologia , Diabetes Mellitus Tipo 2/epidemiologia , Hiperlipidemias/epidemiologia , Hipertensão/epidemiologia , Adulto , Distribuição por Idade , Idoso , Estudos de Casos e Controles , Comorbidade , Doença das Coronárias/diagnóstico , Diabetes Mellitus Tipo 2/diagnóstico , Feminino , Humanos , Hiperlipidemias/diagnóstico , Hipertensão/diagnóstico , Índia/epidemiologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Prevalência , Probabilidade , Valores de Referência , Fatores de Risco , Índice de Gravidade de Doença , Distribuição por Sexo , Taxa de Sobrevida , População UrbanaRESUMO
History as a science revolves around memories, travellers' tales, fables and chroniclers' stories, gossip and trans-telephonic conversations. Medicine itself as per the puritan's definition is a non-exact science because of the probability-predictability-sensitivity-specificity factors. Howsoever, the chronicles of Cardiology in India is quite interesting and intriguing. Heart and circulation was known to humankind from pre-Vedic era. Various therapeutics measures including the role of Yoga and transcendental meditation in curing cardiovascular diseases were known in India. Only recently there has been resurgence of the same globally. There have been very few innovations in Cardiology in India. The cause of this paucity possibly lie in the limited resources. This has a vicious effect on the research mentality of the population who are busy in meeting their daily requirements. This socio-scientific aspect needs a thorough study and is beyond the scope of the present documentation. Present is the future of past and so one must not forget the history which is essentially past that give the present generation the necessary fulcrum to stand in good stead. The present article essentially aims to pay tribute to all the workers and pioneers in the field of Cardiology in India, who in spite of limited resources ventured in an unchartered arena.