Profile of patients with acute myocardial infarction in Turkey: Results from TURK MI registry

Background and Aim:&nbsp;There is no up-to-date study representing Turkish population that gives information about patient profile, treatment choice and prognosis in patients with acute myocardial infarction (AMI). In this study, we present characteristics of AMI patients from a recently conducted TURKMI registry&nbsp;Methods:&nbsp;TURKMI registry included consecutive patients with acute coronary syndromes who were hos- pitalized between 1-15 November 2018 in 50 hospitals representing the country’s population based on 12 Euronuts regions. Demographic characteristics, risk factors, history of cardiovascular diseases and comor- bidities were recorded in each patients.Results:&nbsp;TURKMI Registry included 1930 patients [504 female (26.1%), 1426 male (73.9%), median (IQR) age 62 (53-71)]. Of those, 1191 (61.7%) had NSTEMI, and 739 (38.3%) had STEMI. NSTEMI patients were older (median age 63 (54-72) vs. 60 (51-69); p&lt;0.001). Most of the patients were male (71.3% for NSTEMI and 78.1% for STEMI). Diabetes, hypertension and hyperlipidemia were higher in NSTEMI patients; however, smoking was higher in STEMI patients (Table 1). History of MI, coronary bypass, percutaneous coronary intervention, and heart fail- ure were significantly higher in NSTEMI patients (Table 2). Among the associated disease, chronic obstructive pulmonary disease and chronic kidney disease were significantly higher in NSTEMI patients (Table 3).&nbsp;Conclusions:&nbsp;Most common risk factors in AMI were hypertension and smoking, each of them were avail- able nearly half of the patients. The third and fourth most common risk factor was diabetes and hyperlip- idemia, respectively. Distribution of risk factors differ in STEMI and NSTEMI patients. History of MI and coronary interventions were more common in NSTEMI patients.</div

Demographic, Clinical, and Angiographic Characteristics of Atrial Fibrillation Patients Suffering From de novo Acute Myocardial Infarction: A Subgroup Analysis of the MINOCA-TR Study Population.

BACKGROUND: Atrial fibrillation (AF) prevalence in patients with acute myocardial infarction (MI) ranges from 3% to 25%. However demographic, clinical, and angiographic characteristics of AF patients who admitted with de novo MI are unclear. The aim of this study was to investigate the prevalence of patients presenting with de novo MI with AF. METHODS: The study was performed as a sub-study of the MINOCA-TR (Myocardial Infarction with Non-obstructive Coronary Arteries in Turkish Population) Registry, a multicenter, cross-sectional, observational, all-comer registry. MI patients without a known history of stable coronary artery disease and/or prior coronary revascularization were enrolled in the study. Patients were divided into AF and Non-AF groups according to presenting cardiac rhythm. RESULTS: A total of 1793 patients were screened and 1626 were included in the study. The mean age was 61.5 (12.5) years. 70.7% of patients were men. The prevalence of AF was 3.1% (51 patients). AF patients were older [73.4 (9.4) vs. 61.0 (12.4) years, p<0.001] than non-AF patients. The proportion of women to men in the AF group was also higher than in the non-AF group (43.1% vs. 28.7%, p=0.027). Only 1 out of every 5 AF patients (10 patients, 19.6%) was using oral anticoagulants (OAC). CONCLUSIONS: AF prevalence in patients presenting with de novo MI was lower than previous studies that issued on AF prevalence in MI cohorts. The majority of AF patients did not have any knowledge of their arrhythmia and were not undergoing OAC therapy at admission, emphasizing the vital role of successful diagnostic strategies, patient education, and implementations for guideline adaptation

Treatment delays and in-hospital outcomes in acute myocardial infarction during the COVID-19 pandemic: A nationwide study

© 2020 by Turkish Society of Cardiology.Objective: Delayed admission of myocardial infarction (MI) patients is an important prognostic factor. In the present nationwide registry (TURKMI-2), we evaluated the treatment delays and outcomes of patients with acute MI during the Covid-19 pandemic and compaired with a recent pre-pandemic registry (TURKMI-1). Methods: The pandemic and pre-pandemic studies were conducted prospectively as 15-day snapshot registries in the same 48 centers. The inclusion criteria for both registries were aged ≥18 years and a final diagnosis of acute MI (AMI) with positive troponin levels. The only difference between the 2 registries was that the pre-pandemic (TURKMI-1) registry (n=1872) included only patients presenting within the first 48 hours after symptom-onset. TURKMI-2 enrolled all consecutive patients (n=1113) presenting with AMI during the pandemic period. Results: A comparison of the patients with acute MI presenting within the 48-hour of symptom-onset in the pre-pandemic and pandemic registries revealed an overall 47.1% decrease in acute MI admissions during the pandemic. Median time from symptom-onset to hospital-arrival increased from 150 min to 185 min in patients with ST elevation MI (STEMI) and 295 min to 419 min in patients presenting with non-STEMI (NSTEMI) (p-values <0.001). Door-to-balloon time was similar in the two periods (37 vs. 40 min, p=0.448). In the pandemic period, percutaneous coronary intervention (PCI) decreased, especially in the NSTEMI group (60.3% vs. 47.4% in NSTEMI, p<0.001; 94.8% vs. 91.1% in STEMI, p=0.013) but the decrease was not significant in STEMI patients admitted within 12 hours of symptom-onset (94.9% vs. 92.1%; p=0.075). In-hospital major adverse cardiac events (MACE) were significantly increased during the pandemic period [4.8% vs. 8.9%; p<0.001; age- and sex-adjusted Odds ratio (95% CI) 1.96 (1.20-3.22) for NSTEMI, p=0.007; and 2.08 (1.38-3.13) for STEMI, p<0.001]. Conclusion: The present comparison of 2 nationwide registries showed a significant delay in treatment of patients presenting with acute MI during the COVID-19 pandemic. Although PCI was performed in a timely fashion, an increase in treatment delay might be responsible for the increased risk of MACE. Public education and establishing COVID-free hospitals are necessary to overcome patients' fear of using healthcare services and mitigate the potential complications of AMI during the pandemic