Please use this identifier to cite or link to this item:
https://doi.org/10.3389/fcvm.2021.755822
Title: | Post-ST-Segment Elevation Myocardial Infarction Follow-Up Care During the COVID-19 Pandemic and the Possible Benefit of Telemedicine: An Observational Study. | Authors: | Zhang, Audrey AY Chew, Nicholas WS Ng, Cheng Han Phua, Kailun Aye, Yin Nwe Mai, Aaron Kong, Gwyneth Saw, Kalyar Wong, Raymond CC Kong, William KF Poh, Kian-Keong Chan, Koo-Hui Low, Adrian Fatt-Hoe Lee, Chi-Hang Chan, Mark Yan-Yee Chai, Ping Yip, James Yeo, Tiong-Cheng Tan, Huay-Cheem Loh, Poay-Huan |
Keywords: | COVID-19 ST-segment elevation myocardial infarction pandemic telehealth telemedicine |
Issue Date: | 2021 | Publisher: | Frontiers Media SA | Citation: | Zhang, Audrey AY, Chew, Nicholas WS, Ng, Cheng Han, Phua, Kailun, Aye, Yin Nwe, Mai, Aaron, Kong, Gwyneth, Saw, Kalyar, Wong, Raymond CC, Kong, William KF, Poh, Kian-Keong, Chan, Koo-Hui, Low, Adrian Fatt-Hoe, Lee, Chi-Hang, Chan, Mark Yan-Yee, Chai, Ping, Yip, James, Yeo, Tiong-Cheng, Tan, Huay-Cheem, Loh, Poay-Huan (2021). Post-ST-Segment Elevation Myocardial Infarction Follow-Up Care During the COVID-19 Pandemic and the Possible Benefit of Telemedicine: An Observational Study.. Front Cardiovasc Med 8 : 755822-. ScholarBank@NUS Repository. https://doi.org/10.3389/fcvm.2021.755822 | Abstract: | Background: Infectious control measures during the COVID-19 pandemic have led to the propensity toward telemedicine. This study examined the impact of telemedicine during the pandemic on the long-term outcomes of ST-segment elevation myocardial infarction (STEMI) patients. Methods: This study included 288 patients admitted 1 year before the pandemic (October 2018-December 2018) and during the pandemic (January 2020-March 2020) eras, and survived their index STEMI admission. The follow-up period was 1 year. One-year primary safety endpoint was all-cause mortality. Secondary safety endpoints were cardiac readmissions for unplanned revascularisation, non-fatal myocardial infarction, heart failure, arrythmia, unstable angina. Major adverse cardiovascular events (MACE) was defined as the composite outcome of each individual safety endpoint. Results: Despite unfavorable in-hospital outcomes among patients admitted during the pandemic compared to pre-pandemic era, both groups had similar 1-year all-cause mortality (11.2 vs. 8.5%, respectively, p = 0.454) but higher cardiac-related (14.1 vs. 5.1%, p < 0.001) and heart failure readmissions in the pandemic vs. pre-pandemic groups (7.1 vs. 1.7%, p = 0.037). Follow-up was more frequently conducted via teleconsultations (1.2 vs. 0.2 per patient/year, p = 0.001), with reduction in physical consultations (2.1 vs. 2.6 per patient/year, p = 0.043), during the pandemic vs. pre-pandemic era. Majority achieved guideline-directed medical therapy (GDMT) during pandemic vs. pre-pandemic era (75.9 vs. 61.6%, p = 0.010). Multivariable Cox regression demonstrated achieving medication target doses (HR 0.387, 95% CI 0.164-0.915, p = 0.031) and GDMT (HR 0.271, 95% CI 0.134-0.548, p < 0.001) were independent predictors of lower 1-year MACE after adjustment. Conclusion: The pandemic has led to the wider application of teleconsultation, with increased adherence to GDMT, enhanced medication target dosing. Achieving GDMT was associated with favorable long-term prognosis. | Source Title: | Front Cardiovasc Med | URI: | https://scholarbank.nus.edu.sg/handle/10635/206171 | ISSN: | 2297055X | DOI: | 10.3389/fcvm.2021.755822 |
Appears in Collections: | Staff Publications Elements |
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