Table 1

Demographics, clinical characteristic, management strategy and outcome in patients with cardiovascular emergencies

Pre-COVID periodPre-lockdown periodLockdown periodP value
No of emergency admissions1488830289
Age (years) (mean±SD)61.1±11.958.1±11.261.7±12.4<0.001
Men (n (%))1057 (71.04)597 (71.93)257 (88.93)<0.001
STEMI (n (%)588 (39.52)276 (33.25)192 (66.44)<0.001
NSTEMI (n (%))504 (33.87)336 (40.48)36 (12.46)<0.001
Acute decompensated heart failure (n (%))240 (16.13)112 (13.49)31 (10.73)0.030
Advanced* or third degree AV block† (n (%))156 (10.48)106 (12.77)30 (10.38)0.021
Management of STEMI (n (%))
 Outside window period36 (6.12)48 (17.39)48 (25.00)<0.001
 Thrombolysis108 (18.37)85 (30.80)62 (32.29)<0.001
 Pharmacoinvasive‡168 (28.57)71 (25.072)46 (23.96)0.002
 Primary percutaneous coronary intervention276 (46.94)72 (26.09)36 (18.75)<0.001
NSTEMI patients managed conservatively (n (%))32 (6.34)69 (20.54)29 (80.56)<0.001
ACS patients associated with risk factors§ (n (%))120 (10.99)108 (17.65)71 (31.14)<0.001
Ejection fraction (%) (mean±SD)47.52±10.043.63±9.637.85±10.4<0.001
Inhospital mortality (n (%))40 (2.69)29 (3.49)21 (7.27)<0.001
  • The pre-COVID period was defined as the period when there were no COVID-19 cases (25 January to 24 February 2020), the pre-lockdown period was defined as the period when there were COVID-19 cases but no lockdown was imposed (25 February to 24 March 24) and the lockdown period was defined as the period when total lockdown was imposed by the government of India (25 March to 24 April 2020).

  • *Advanced, high grade or high degree of AV block: ≥2 consecutive P waves at a constant physiological rate that did not conduct to the ventricles with evidence of some AV conduction.

  • †Third degree AV block (complete heart block): no evidence of AV conduction.

  • ‡Pharmacoinvasive approach is defined as a strategy where fibrinolysis is followed by immediate transfer to a PCI capable hospital for either rescue PCI in the case of failed fibrinolysis or routine coronary angiography and PCI in the case of successful fibrinolysis.

  • §Risk factors associated with poor prognosis in ACS were cardiogenic shock, heart failure, ventricular arrhythmia, complete heart block and acute kidney injury.

  • ACS, acute coronary syndrome; AV, atrioventricular; NSTEMI, non-ST elevation myocardial infarction; PCI, percutaneous coronary intervention; STEMI, ST elevation myocardial infarction.