Rural heart attack patients started taking longer to seek care when the pandemic began
Rural patients started waiting longer to seek medicare attention for a ST-elevation myocardial infarction (STEMI) during the early stages of the COVID-19 pandemic, according to new data published in the American Journal of Cardiology. The study focused on parts of the United States where COVID-19 was not terribly prevalent, making the team's findings even more noteworthy.
Researchers analyzed data from nearly 1,300 STEMI patients treated between Jan. 1, 2016, and April 30, 2020. All patients received care at one of 27 different facilities in 13 mostly rural counties in Michigan.
Seventy-one percent of the patients were men, and the median patient age was 63 years old.
While 96.8% of patients presented in the pre-COVID-19 era, the rest of the cohort presented during the early months of the pandemic.
The primary focus of the analysis was the amount of time that passed between when patients first experienced symptoms and when they first arrival at a medical facility. Overall, the group wrote, presentation delays greater than 12 hours were seen among 19.5% of patients during the pandemic, but just 2.4% of patients before the pandemic.
Also, presentation delays greater than 24 hours were seen among 14.6% of patients during the pandemic and 0% of patients before the pandemic.
“Despite the geographic area served by the STEMI network in this study having fewer than 1/10 the number of infections observed in Metro Detroit, significant delays in seeking medical care were nonetheless observed,” wrote lead author David A. McNamara, MD, a specialist with Spectrum Health in Grand Rapids, Michigan, and colleagues. “This suggests much of the pandemic's effect on STEMI presentations may have been indirect in nature. One potential hypothesis for this finding is that the COVID-19 pandemic because of fears of contracting the virus in the medical setting; however, as this study did not survey patients with STEMI as to the underlying etiology of their delayed presentation, no definitive conclusion can be drawn as to the explanation."
These delays, the group wrote, are "of particular importance" considering the relationship between delayed STEMI care and patient outcomes.
"Physicians in areas with low COVID-19 rates should be vigilant for a possible influx of resultant ischemia-mediated heart failure in the months to years to come," they added.
Read the full study here.