Trends in emergency myocardial infarction admissions during COVID-19 and the war in Ukraine: a hospital-based time-series analysis from Western Ukraine

BACKGROUND: The COVID-19 pandemic and the full-scale Russian invasion (FSI) of Ukraine have disrupted healthcare systems and altered hospital utilisation for myocardial infarction (MI) care. This study aimed to assess trends in emergency ambulance admissions for MI and changes in the clinico-demographic profile of admitted patients at a secondary healthcare centre in western Ukraine in 2018–2024. METHODS: The retrospective analysis of electronic medical records for patients admitted with MI between January 2018 and December 2024 to Ivano-Frankivsk Central City Clinical Hospital was conducted. Only emergency ambulance admissions from Ivano-Frankivsk city or suburban zones were included. The study period was divided into four phases: pre-COVID-19, COVID-19, overlapping COVID-19–FSI period, and FSI after lifting most COVID-19 restrictions. RESULTS: Over 2018–2024, 926 MI admissions were recorded (31.3% pre-COVID-19, 28.7% COVID-19, 20.7% COVID-19–FSI, 19.2% FSI-post-COVID-19). No immediate level change was observed at COVID-19 onset; instead, admissions shifted to a significant declining trend during COVID-19, followed by a trend reversal after the start of the FSI. In contrast, the clinico-demographic profile remained broadly similar across all four periods. The median length of stay shortened during COVID-19 and partially normalised to pre-COVID-19 levels thereafter. CONCLUSION: In this study, the COVID-19 pandemic and the ongoing FSI substantially altered hospital admission patterns for MI, without major shifts in the clinico-demographic profile of admitted patients.