During the pandemic,
mortality from acute myocardial infarctions (AMI)
increased by 15% compared to 2019, and this increase was even greater among women and adults under 60 years of age.
These conclusions are based on a study carried out by researchers from the Argentine Society of Cardiology (SAC), who attributed this panorama of deaths to the
"inhibitions"
to approach the guards while the mandatory quarantine was in force.
In 2021 there were "nine more deaths from AMI per 100,000 inhabitants than those that occurred in 2019," states the study, published in the SAC magazine.
Under the signature of six researchers, in a group led by Adrián Charask, the director of the National Registry of Acute Myocardial Infarction with ST Segment Elevation, it is detailed that while in 2019 there were 17,789 deaths from AMI, in 2020
there were 18,881, and 20,901 in 2021.
This last data implies a figure slightly higher than what is recorded for 2022 in the Vital Statistics report of the Ministry of Health, published this January, which counts
20,603 deaths from heart attacks.
A study reveals the incidence of deaths from acute myocardial infarction and the impact of the pandemic.
Excess deaths for any reason in the 2020-2021 biennium, that is, the difference between the deaths actually produced and what was expected from what happened in the previous four years, was 18.2% and this gap is explained, fundamentally ,
due to the Covid-19 pandemic.
In 2021, furthermore, the coronavirus became the leading cause of mortality (in general terms), followed by heart disease, influenza and cerebrovascular diseases.
On the other hand, in 2022,
diseases of the circulatory system were once again the leading cause of death
- with 110,062 deaths -, followed by diseases of the respiratory system - with 74,698 cases -.
"In the pandemic there was a strong increase in mortality, attributable to covid, and an increase in mortality from acute myocardial infarction - especially in women and those under 60 years of age -, probably attributable to the side
effects of Preventive Social Isolation and Mandatory (ASPO)"
, say the conclusions of the article titled "Mortality of acute myocardial infarction in Argentina during the COVID-19 pandemic."
In dialogue with Télam, Charask stated that the 15% increase in mortality due to AMI "is really an important number."
"We think that the main causes may be two: the ASPO - which could have inhibited the patient from going to the emergency room - and, on the other hand, that (the additional deaths) have been caused by the same covid, which caused
cardiovascular problems. ,
specifically thrombotic events or even myocarditis that could have been confused with heart attacks," he said.
"But our biggest hypothesis is that the ASPO is the one that developed this event," added who is also head of cardiology admission at the Bazterrica and Santa Isabel clinics.
What is myocardial infarction
Myocardial infarction is the condition caused by the death of a region of the heart muscle as a result of the
complete obstruction of a coronary artery
.
It occurs when a blood clot obstructs that pathway previously affected by arteriosclerosis.
As a result of this obstruction, the blood supply to that area is suppressed and, after a time, the tissue irreversibly dies.
Charask explained that "infarcts are divided into two groups" that are technically known as "infarcts without ST elevation" and "infarcts with ST elevation" - depending on the appearance or not of changes in the electrocardiogram that require urgent opening of the heart. the artery.
The study deals with the latter, which are precisely those in which "time is life."
"The heart has three coronary arteries, if one of them becomes clogged, the time it takes to unclog it is what determines the prognosis: if you are in the hospital, we will unclog it in minutes and your survival will be greater than 99%; but If they pass
3, 4 or 5 hours, mortality increases enormously,"
he said.
It is that, with a simple electrocardiogram, "which is the key to all this, you can know specifically if a patient has a heart attack and if reperfusion treatment (recanalization) - which involves giving a drug that unclogs the artery - or directly perform an angioplasty by placing a catheter, and then a stent, so that the flow returns again", an operation that implies
"a change between life and death."
Although the Ministry of Health statistics do not discriminate between hospital and out-of-hospital deaths, the presumption is that "the majority" occurs outside of healthcare centers because "an analysis carried out in Bariloche shows that mortality from heart attacks is
90% extra." hospital,
and we, through the Registry, know that in-hospital mortality is around 9 or 10%.
Furthermore, comparatively, in 2020 and 2021, mortality from heart attacks grew more among women -19%- and among adults under 60 years of age -73%-.
Regarding gender disparity, the specialist explained that through different studies they have been warning that "not only do women consult less and are less aware that the main cause of death is cardiovascular disease" at the country level, both in men and women. in women, "but doctors
overlay cardiovascular disease" in them, not performing adequate studies.
"Women get heart disease 10 years later and the median age for heart attacks is around 67 years, but even though arteriosclerotic disease occurs later,
when it occurs it is more serious.
That is why half of "the deaths correspond to women despite the fact that only one in four heart attacks with ST elevation occur in women," he said.
Younger infarcted patients
On the other hand, deaths from AMI among those under 60 years of age increased by 73% in relation to the pre-pandemic, with the increase being smaller among those over that age.
Among adults
between 20 and 59 years old, mortality from AMI skyrocketed,
the doctor says, "because being young and therefore feeling healthier, they went to the wards less for fear of catching Covid."
Charask explained that the comparison of this study with the next ones carried out based on the Vital Statistics of 2022, recently published, will allow us to see if deaths from AMI have once again "leveled off" as was happening between 2017 and 2019. But this analysis still this slope.
S.C.