{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T11:01:32Z","timestamp":1789988492461,"version":"4.0.1"},"reference-count":18,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T00:00:00Z","timestamp":1789689600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clin. Pract.","Clinics and Practice"],"abstract":"<jats:p>Background and Aim: Studies worldwide have documented a reduction in acute myocardial infarction (AMI) admissions during the COVID-19 pandemic. We aimed to assess AMI admissions, management, and in-hospital outcomes in Kosovo during the pandemic period. Methods: We conducted a retrospective single-centre study including all consecutive AMI admissions from 1 January 2018 to 31 December 2020 at the Clinic of Cardiology, University Clinical Centre of Kosovo, the only public tertiary primary percutaneous coronary intervention (PCI) centre in the country. The pre-pandemic (PP) period was defined as 1 January 2018\u201312 March 2020 and the ongoing pandemic (OP) period as 13 March\u201331 December 2020. Demographic, clinical, laboratory, angiographic, and outcome data were collected. In-hospital mortality was defined as death between admission and discharge. Interrupted time-series analyses were performed. Results: A total of 898 AMI patients were admitted during OP and 2955 during PP. Daily admissions decreased from 3.8\/day to 3.05\/day (p &lt; 0.001). OP patients were younger, more often hypertensive and smokers, and more frequently male. Coronary angiography (81% vs. 76%, p = 0.001) and PCI (66% vs. 60%, p = 0.001) were more frequent during OP, while in-hospital mortality remained unchanged. Time-series analysis showed a sharp fall in admissions at OP (\u03b2 = \u221212.66, p &lt; 0.001) with gradual recovery, alongside an increase in PCI use (\u03b2 = 0.184, p &lt; 0.001) and stable mortality. The proportion of ST-segment elevation (STEMI) cases increased significantly during the pandemic period. Compared with the pandemic period, admission during the pre-pandemic period was associated with lower odds of undergoing PCI (aOR 0.81, 95% CI 0.69\u20130.95), while age \u2265 65 reduced the likelihood of PCI. Conclusions: AMI hospitalizations in Kosovo declined significantly during the COVID-19 pandemic. The pandemic cohort was younger, with the profile of admitted patients shifting toward younger age, male sex, and STEMI presentation. Despite fewer admissions, PCI use increased, while no statistically significant difference in in-hospital mortality was observed between the two periods. These findings describe changes in treatment patterns and short-term in-hospital outcomes during the pandemic but should not be interpreted as evidence of equivalent overall quality of AMI care.<\/jats:p>","DOI":"10.3390\/clinpract16090171","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T09:01:38Z","timestamp":1789981298000},"page":"171","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Effect of the COVID-19 Pandemic on Myocardial Infarction Care in Kosovo"],"prefix":"10.3390","volume":"16","author":[{"given":"Zarife","family":"Rexhaj","sequence":"first","affiliation":[{"name":"Clinic of Cardiology, University Clinical Centre of Kosova, 10000 Prishtina, Kosovo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9529-0770","authenticated-orcid":false,"given":"Besfort","family":"Kryeziu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Medical Faculty, University of Prishtina, 10000 Prishtina, Kosovo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Premtim","family":"Rashiti","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Medical Faculty, University of Prishtina, 10000 Prishtina, Kosovo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pranvera","family":"Ibrahimi","sequence":"additional","affiliation":[{"name":"Clinic of Cardiology, University Clinical Centre of Kosova, 10000 Prishtina, Kosovo"},{"name":"Department of Public Health and Clinical Medicine, Ume\u00e5 University, 901 87 Ume\u00e5, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arlind","family":"Batalli","sequence":"additional","affiliation":[{"name":"Clinic of Cardiology, University Clinical Centre of Kosova, 10000 Prishtina, Kosovo"},{"name":"Department of Public Health and Clinical Medicine, Ume\u00e5 University, 901 87 Ume\u00e5, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3454-0847","authenticated-orcid":false,"given":"Afrim","family":"Poniku","sequence":"additional","affiliation":[{"name":"Clinic of Cardiology, University Clinical Centre of Kosova, 10000 Prishtina, Kosovo"},{"name":"Department of Public Health and Clinical Medicine, Ume\u00e5 University, 901 87 Ume\u00e5, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margarit\u00eb","family":"Gjoka","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Medical Faculty, University of Prishtina, 10000 Prishtina, Kosovo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6089-5614","authenticated-orcid":false,"given":"Michael","family":"Henein","sequence":"additional","affiliation":[{"name":"Imperial College, London W12 0BZ, UK"},{"name":"Siena University, 53100 Siena, Italy"},{"name":"University of Nicosia, Egkomi 2408, Cyprus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0426-0243","authenticated-orcid":false,"given":"Shpend","family":"Elezi","sequence":"additional","affiliation":[{"name":"Clinic of Cardiology, University Clinical Centre of Kosova, 10000 Prishtina, Kosovo"},{"name":"Department of Internal Medicine, Medical Faculty, University of Prishtina, 10000 Prishtina, Kosovo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0410-968X","authenticated-orcid":false,"given":"Gani","family":"Bajraktari","sequence":"additional","affiliation":[{"name":"Clinic of Cardiology, University Clinical Centre of Kosova, 10000 Prishtina, Kosovo"},{"name":"Department of Internal Medicine, Medical Faculty, University of Prishtina, 10000 Prishtina, Kosovo"},{"name":"Department of Public Health and Clinical Medicine, Ume\u00e5 University, 901 87 Ume\u00e5, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"102433","DOI":"10.1016\/j.jaut.2020.102433","article-title":"The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak","volume":"109","author":"Rothan","year":"2020","journal-title":"J. Autoimmun."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1715","DOI":"10.1016\/S0140-6736(20)30854-0","article-title":"Estimating excess 1-year mortality associated with the COVID-19 pandemic according to underlying conditions and age: A population-based cohort study","volume":"395","author":"Banerjee","year":"2020","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e70004","DOI":"10.1111\/irv.70004","article-title":"Prevalence of SARS-CoV-2 Antibodies in Kosovo-Wide Population-Based Seroepidemiological Study","volume":"18","author":"Ramadani","year":"2024","journal-title":"Influenza Other Respi. Viruses"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2083","DOI":"10.1093\/eurheartj\/ehaa409","article-title":"Reduction of hospitalizations for myocardial infarction in Italy in the COVID-19 era","volume":"41","author":"Spaccarotella","year":"2020","journal-title":"Eur. Heart J."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2871","DOI":"10.1016\/j.jacc.2020.04.011","article-title":"Reduction in ST-Segment Elevation Cardiac Catheterization Laboratory Activations in the United States During COVID-19 Pandemic","volume":"75","author":"Garcia","year":"2020","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1852","DOI":"10.1093\/eurheartj\/ehaa314","article-title":"Decline of acute coronary syndrome admissions in Austria since the outbreak of COVID-19: The pandemic response causes cardiac collateral damage","volume":"41","author":"Metzler","year":"2020","journal-title":"Eur. Heart J."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1016\/S0140-6736(20)31356-8","article-title":"COVID-19 pandemic and admission rates for and management of acute coronary syndromes in England","volume":"396","author":"Mafham","year":"2020","journal-title":"Lancet"},{"key":"ref_8","first-page":"210","article-title":"Admission of patients with STEMI since the outbreak of the COVID-19 pandemic: A survey by the European Society of Cardiology","volume":"6","author":"Camm","year":"2020","journal-title":"Eur. Heart J.-Qual. Care Clin. Outcomes"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"100686","DOI":"10.1016\/j.ijcha.2020.100686","article-title":"Effect of COVID-19 on acute treatment of ST-segment elevation and Non-ST-segment elevation acute coronary syndrome in northwestern Switzerland","volume":"32","author":"Boeddinghaus","year":"2021","journal-title":"IJC Heart Vasc."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/j.ahj.2020.04.022","article-title":"Impact of COVID-19 pandemic on patients with ST-segment elevation myocardial infarction: Insights from a British cardiac center","volume":"226","author":"Abdelaziz","year":"2020","journal-title":"Am. Heart J."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1002\/ehf2.13075","article-title":"Increased mortality and worse cardiac outcome of acute myocardial infarction during the early COVID-19 pandemic","volume":"8","author":"Primessnig","year":"2021","journal-title":"ESC Heart Fail."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e167","DOI":"10.3346\/jkms.2022.37.e167","article-title":"Impact of the COVID-19 Pandemic on Patient Delay and Clinical Outcomes for Patients With Acute Myocardial Infarction","volume":"37","author":"Choi","year":"2022","journal-title":"J. Korean Med. Sci."},{"key":"ref_13","first-page":"82","article-title":"Impact of the COVID-19 pandemic on interventional cardiology activity in Spain","volume":"2","author":"Ojeda","year":"2022","journal-title":"REC Interv. Cardiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1186\/s12933-020-01196-0","article-title":"Impact of COVID-19 pandemic and diabetes on mechanical reperfusion in patients with STEMI: Insights from the ISACS STEMI COVID 19 Registry","volume":"19","author":"Cercek","year":"2020","journal-title":"Cardiovasc. Diabetol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e009654","DOI":"10.1161\/CIRCINTERVENTIONS.120.009654","article-title":"Impact of the COVID-19 Pandemic on Percutaneous Coronary Intervention in England","volume":"13","author":"Kwok","year":"2020","journal-title":"Circ. Cardiovasc. Interv."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1056\/NEJMc2009166","article-title":"Reduced Rate of Hospital Admissions for ACS during Covid-19 Outbreak in Northern Italy","volume":"383","author":"Angelini","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1419","DOI":"10.1001\/jamacardio.2020.3629","article-title":"Case Rates, Treatment Approaches, and Outcomes in Acute Myocardial Infarction During the Coronavirus Disease 2019 Pandemic","volume":"5","author":"Gluckman","year":"2020","journal-title":"JAMA Cardiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e536","DOI":"10.1016\/S2468-2667(20)30188-2","article-title":"Hospital admissions for acute myocardial infarction before and after lockdown according to regional prevalence of COVID-19 and patient profile in France: A registry study","volume":"5","author":"Mesnier","year":"2020","journal-title":"Lancet Public Health"}],"container-title":["Clinics and Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2039-7283\/16\/9\/171\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T10:20:34Z","timestamp":1789986034000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2039-7283\/16\/9\/171"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,18]]},"references-count":18,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["clinpract16090171"],"URL":"https:\/\/doi.org\/10.3390\/clinpract16090171","relation":{},"ISSN":["2039-7283"],"issn-type":[{"value":"2039-7283","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,18]]}}}