MI data from California echo findings in Italy of a pandemic dip

  • Solomon MD & al.
  • N Engl J Med
  • 19 May 2020

  • curated by Emily Willingham, PhD
  • Clinical Essentials
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Takeaway

  • As the COVID-19 pandemic heated up, incidence of acute myocardial infarction (MI) hospitalizations dropped in a large California hospital system, echoing findings from Italy.

Why this matters

  • Concerns have arisen that people are avoiding emergency calls for crucial conditions, such as MI, and that this reluctance might underlie these declining rates.

Key results

  • 43,017,810 person-weeks evaluated, covering January 1-April 14, 2020.
  • From January 1, 2020 to March 3, 2020, incidence rate of MI hospitalizations was 4.1 per 100,000 person-weeks.
  • From April 8, 2020 to April 14, 2020, that rate was 2.1 per 100,000 person-weeks.
  • The incidence rate ratio was 0.52 (95% CI, 0.40-0.68).
  • The pattern was similar for ST-elevation MI vs non-ST-elevation MI.
  • In addition, vs patients presenting prepandemic, those presenting from March 4, 2020 to April 14, 2020 had a lower prevalence of coronary artery disease, previous acute MI, or percutaneous coronary intervention.

Study design

  • Data from Kaiser Permanente of Northern California system (21 medical centers; 255 clinics) were analyzed.
  • Funding: Permanente Medical Group Delivery Sciences and Applied Research and Physician Researcher programs.

Limitations

  • Single large center.
  • No causation established.
  • Misdiagnosis possible.