COVID-19 Pandemisi Sırasında Akut Koroner Sendromların Zamansal Dinamikleri: Pandemi Öncesi, Pandemi ve Pandemi Sonrası Dönemler Arasında Retrospektif Karşılaştırmalı Bir Analiz

Yıl 2025, Cilt: 8 Sayı: 1, 45 - 51, 28.02.2025

Abdulkadir Çakmak , Ömer Kertmen

https://doi.org/10.53446/actamednicomedia.1602347

Öz

Amaç: SARS-CoV-2’nin neden olduğu COVID-19 pandemisi, küresel sağlık sistemlerini ciddi şekilde etkileyerek kardiyovasküler sağlığı derinden etkilemiştir. Bu çalışma, pandemi öncesi, pandemi ve pandemi sonrası dönemlerde ST-yükselmeli miyokard enfarktüsü (STEMI), ST-yükselmesiz miyokard enfarktüsü (NSTEMI) ve stabil olmayan angina pektoris (USAP) gibi akut koroner sendromların (AKS) zamansal eğilimlerini değerlendirmektedir.
Yöntem: Bu retrospektif gözlemsel çalışma, Ocak 2018 ile Haziran 2024 tarihleri arasında bir üçüncü basamak kardiyovasküler merkezde AKS tanısı alan hastaları içermektedir. Hastalar üç kohorta ayrılmıştır: pandemi öncesi (Ocak 2018-Şubat 2020), pandemi (Mart 2020-Nisan 2022) ve pandemi sonrası (Mayıs 2022-Haziran 2024).
Bulgular: STEMI ve NSTEMI insidansı, diğer dönemlere kıyasla pandemi sonrası dönemde anlamlı şekilde artmıştır (p<0,001). USAP vakalarının sayısı ise pandemi ve pandemi sonrası dönemlerde anlamlı olarak daha düşüktür (p<0,01). Zamansal analiz, STEMI/NSTEMI vakaları ile zaman arasında pozitif bir korelasyon olduğunu göstermiştir (p<0,0001). Ancak USAP insidansı ile zaman arasında anlamlı bir korelasyon saptanmamıştır. Bu eğilimler, pandemiye bağlı gecikmiş sağlık hizmetlerine erişim ile inflamatuvar ve trombotik mekanizmaların miyokard enfarktüsü vakalarındaki artışın ana nedenleri olduğunu ortaya koymaktadır.
Sonuç: Bulgular, pandeminin AKS sunumları üzerindeki kalıcı etkisini vurgulamakta ve adaptif sağlık sistemlerine duyulan ihtiyacı işaret etmektedir. Gelecekteki krizlerin uzun vadeli kardiyovasküler sonuçlarını azaltmak için anti-inflamatuvar yaklaşımlar içeren stratejiler ve dirençli sağlık sistemleri gereklidir. Bu bulguların doğrulanması ve ilgili mekanizmaların daha iyi anlaşılması için çok merkezli çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

Akut koroner sendromlar, COVID-19, NSTEMI, STEMI, UAP

Temporal Dynamics of Acute Coronary Syndromes During the COVID-19 Pandemic: A Retrospective Comparative Analysis Across Pre-Pandemic, Pandemic, and Post-Pandemic Phases

Öz

Objective: The COVID-19 pandemic, caused by SARS-CoV-2, disrupted global healthcare systems and significantly influenced cardiovascular health. This study examines the temporal trends of acute coronary syndromes (ACS), including ST-elevation myocardial infarction (STEMI), non-ST-elevation myocardial infarction (NSTEMI), and unstable angina pectoris (USAP), across pre-pandemic, pandemic, and post-pandemic periods.
Methods: This retrospective observational study was conducted at a single tertiary cardiovascular center involving patients diagnosed with ACS from January 2018 to June 2024. Patients were stratified into three cohorts: pre-pandemic (January 2018-February 2020), pandemic (March 2020-April 2022), and post-pandemic (May 2022-June 2024).
Results: The incidence of STEMI and NSTEMI significantly increased in the post-pandemic period compared to those in the other periods (p<0.001). The number of USAP cases was significantly lower during the pandemic and post-pandemic periods (p<0.01). Temporal analyses revealed a positive correlation between time and STEMI/NSTEMI cases (p<0.0001). However, USAP incidence showed no significant correlation with time. These trends suggest that delayed healthcare access and pandemic-related inflammatory and thrombotic mechanisms are key drivers of increased myocardial infarction cases.
Conclusion: The findings underscore the enduring impact of the pandemic on ACS presentations, highlighting the need for adaptive healthcare systems. Strategies incorporating anti-inflammatory approaches and resilient healthcare frameworks are essential for mitigating the long-term cardiovascular consequences of future crises. Further multicenter studies are recommended to validate these findings and to enhance our understanding of the mechanisms involved.

Anahtar Kelimeler

Acute coronary syndromes, COVID-19, NSTEMI, STEMI, UAP

Etik Beyan

The study was approved by Amasya University Non-Interventional Clinical Research Ethics Committee (Date: 26 November 2024, No: 2024/123).

Kaynakça

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