Araiza-Garaygordobil, DMontalto, CMartinez-Amezcua, PCabello-Lopez, AGopar-Nieto, RAlabrese, RAlmaghraby, ACatoya-Villa, SChacon-Diaz, MKaufmann, C CCorbi-Pascual, MDeharo, PEl-Tahlawi, MElgohari-Abdelwahab, AGuerra, FJarakovic, MMartinez-Gomez, EModerato, LMontero, SMorejon-Barragan, POmar, A MJorge-Pérez, PPrzybyło, PSelim, ESinan, U YStratinaki, MTica, OTrêpa, MariaUribarri, AUzokov, JWilk, KCzerwińska-Jelonkiewicz, KSionis, AGierlotka, MLeonardi, SKrychtiuk, K ATavazzi, G2023-10-172023-10-172021Araiza-Garaygordobil D, Montalto C, Martinez-Amezcua P, et al. Impact of the COVID-19 pandemic on hospitalizations for acute coronary syndromes: a multinational study. QJM. 2021;114(9):642-647. doi:10.1093/qjmed/hcab0131460-27251460-2393http://hdl.handle.net/10400.16/2817Background: COVID-19 has challenged the health system organization requiring a fast reorganization of diagnostic/therapeutic pathways for patients affected by time-dependent diseases such as acute coronary syndromes (ACS). Aim: To describe ACS hospitalizations, management, and complication rate before and after the COVID-19 pandemic was declared. Design: Ecological retrospective study. Methods: We analyzed aggregated epidemiological data of all patients > 18 years old admitted for ACS in twenty-nine hub cardiac centers from 17 Countries across 4 continents, from December 1st, 2019 to April 15th, 2020. Data from December 2018 to April 2019 were used as historical period. Results: A significant overall trend for reduction in the weekly number of ACS hospitalizations was observed (20.2%; 95% confidence interval CI [1.6, 35.4] P = 0.04). The incidence rate reached a 54% reduction during the second week of April (incidence rate ratio: 0.46, 95% CI [0.36, 0.58]) and was also significant when compared to the same months in 2019 (March and April, respectively IRR: 0.56, 95%CI [0.48, 0.67]; IRR: 0.43, 95%CI [0.32, 0.58] p < 0.001). A significant increase in door-to-balloon, door-to-needle, and total ischemic time (p <0.04 for all) in STEMI patents were reported during pandemic period. Finally, the proportion of patients with mechanical complications was higher (1.98% vs. 0.98%; P = 0.006) whereas GRACE risk score was not different. Conclusions: Our results confirm that COVID-19 pandemic was associated with a significant decrease in ACS hospitalizations rate, an increase in total ischemic time and a higher rate of mechanical complications on a international scale.engCOVID-19journal article10.1093/qjmed/hcab013