Impact of the COVID-19 pandemic on the treatment and prognosis of acute myocardial infarction in Xuzhou, China

The treatment of acute myocardial infarction (AMI) during the COVID-19 pandemic has been affected to varying degrees. This study is the first to explore the impact of COVID-19 on the treatment and prognosis of rural and urban AMI in developing countries.A total of 128 patients with AMI in our hospital during the COVID-19 pandemic were enrolled. A total of 197 patients diagnosed with AMI before the COVID-19 pandemic were selected as the control group and one year of follow-up was performed.Hospital stay and the proportion of Killip class ≥ 2 patients were increased among rural AMI patients in the 'during COVID-19' group, compared with the 'before COVID-19' group. Among ST-segment elevation myocardial infarction (STEMI) total and rural STEMI patients, the treatment time in the during-COVID-19 group was longer than that in the before-COVID-19 group, whereas only the symptom to door (S to D) total and door to balloon (D to B) were extended in urban STEMI patients. In AMI total and rural AMI patients, major adverse cardiovascular events (MACEs) and all-cause mortality were increased in the during-COVID-19 group compared with the before-COVID-19 group. Kaplan-Meier analysis revealed that the survival and occurrence of MACEs in AMI total and rural AMI patients were significantly higher in the during-COVID-19 group.The COVID-19 pandemic led to delayed treatment and worse prognosis in AMI patients. Rural areas appear to be at a greater risk.