Akademik Veri Yönetim Sistemi
ANGIOLOGY, 2024 (SCI-Expanded, Scopus)
Acute ST-elevation myocardial infarction (STEMI) is a critical condition where coronary collaterals can mitigate myocardial damage. The Coronavirus Disease 2019 (COVID-19) pandemic introduced unique challenges in STEMI management, potentially affecting outcomes. This study evaluates the efficacy of coronary collaterals during the pandemic compared to the post-pandemic period. A review of 1465 STEMI patients treated at a high-volume tertiary care center from April 2020 to December 2022 was conducted. Collaterals were assessed using the Rentrop classification. In-hospital mortality and 1-year major adverse cardiac events (MACE) were analyzed based on collateral status and timeframes. During the pandemic, there was a higher incidence of robust collaterals (28.2% vs 23.2%, P =.04), but they were less protective, with similar in-hospital mortality (14.4% vs 8.1%, P =.07) and 1-year MACE rates (21.9% vs 30.4%, P =.09) across groups. Post-pandemic, robust collaterals showed significant protective effects with reduced in-hospital mortality (3.6% vs 7.4%, P =.04) and 1-year MACE rates (17.1% vs 24.9%, P =.03). These findings highlight a dynamic role of collaterals in STEMI management, with the pandemic impairing their functionality. This underscores the need for adaptive STEMI care strategies, especially during global health crises.