Clinical Characteristics and Invasive Management of Acute Myocardial Infarction in the Post–COVID-19 Era

Background: Organizing healthcare delivery during an epidemic is a major challenge that reshapes patient experience and can have lasting effects on perceptions of care and on the healthcare system’s structure and function. The study analyzed how the COVID-19 pandemic altered the profile of myocardial infarction (MI) patients treated at the University Hospital in Krakow. Methods: Data on diagnostic and interventional procedures performed in patients with MI were collected from February 2018 to July 2024 and divided into three equal periods: before, during, and after the COVID-19 pandemic. Risk factors were interview-based and not validated against laboratory data. Results: Of 2 703 procedures, 855 were pre-COVID (31.63%), 842 during COVID (31.15%) and 1 006 post-COVID (37.22%). During COVID, NSTEMI increased relative to STEMI (p = 0.0081). Age was similar across periods, but risk profiles differed: hypertension was unchanged, while smoking (23.63% vs. 14.73% vs. 13.62%, p < 0.0001), diabetes (24.44% vs. 24.35% vs. 15.90%, p < 0.0001) and kidney disease (6.67% vs. 4.99% vs. 2.68%, p < 0.0001) have a lower documented prevalence post-COVID. Referrals were predominantly for PCI (76.02% vs. 76.60% vs. 75.84%), infrequently for CABG (7.37% vs. 4.63% vs. 5.67%), and similar for conservative treatment (16.61% vs. 18.76% vs. 18.49%, p = 0.1416). Angiography complications (death or sudden cardiac arrest) stayed <1% and PCI complications <2%, with no between-period differences. Conclusions: In the immediate post-pandemic period, myocardial infarction (MI) hospitalizations increased by about 20% compared with the pandemic phase, along with a proportional rise in diagnostic and therapeutic invasive procedures, despite a lower documented prevalence of traditional coronary artery disease risk factors in the post-pandemic cohort.