Coronary disease & ACSCross-sectional study
Factors Underlying Reduced Hospitalizations for Myocardial Infarction During the COVID-19 Pandemic
- Cross-sectional study
Expected rates accounted for shifts in population characteristics and the prepandemic temporal trend (2016-2019)
Authors' conclusion
The early reduction in AMI encounters was likely driven by care avoidance, while ongoing reductions through June 2023 likely reflect long-standing temporal trends. During the pandemic, there were 5% fewer AMI encounters than expected.
Study context
- Population
- All patients enrolled in traditional Medicare, US, January 2016 to June 20232,846,153,487 patient-months
- Exposure
- Observed vs expected acute myocardial infarction (AMI) hospital encounter rates during the COVID-19 pandemic
- Outcome
- Hospital encounters for AMI (ED visits, observation stays or inpatient admissions)
Main finding
As reported in the abstract
AMI hospital encounters per 100 patients, June 2023
0.044
AMI hospital encounters per 100 patients, June 2019
0.055
June 2023 vs June 2019
20% lower
Fewer AMI encounters than expected, March 2020 to June 2023 (95% prediction interval 1%-9%)
5%
Observational data: associations, not effects.
Further findings
Drivers of the decline
- Early in the pandemic, AMI rates moved inversely with COVID-19 death rates and tracked other painful acute conditions (e.g., nephrolithiasis), suggesting care avoidance
- Changes in patient characteristics driven by excess deaths explained little of the decline
- By April 2022, observed rate matched the expected rate accounting for the long-standing downward trend
Original publication
Summarised from the published abstract; every number is checked against it