Introduction

The impact of COVID-19 pandemic and pandemic-related social restrictions on the rate of lifestyle-related risk factors (such as physical inactivity and unhealthy diet) in patients with myocardial infarctions (MIs) has not been investigated before.    

Methods

Lifestyle-related risk factors of patients admitted to hospital with MI were analyzed during the last 9 years using the database of the multicenter IPP (Intensive Prevention Program) and NET-IPP (New Technologies in Intensive Prevention Programs) trials. The IPP trial was performed from 2014 to 2016; NET-IPP is recruiting patients since 2018 and is ongoing. 

A comparison of patients with MI in the years before (2014-2019) vs. during (2020-2022) COVID-19 pandemic was performed with respect to the following risk factors: physical inactivity (definition: no leisure time physical activity), unhealthy diet (definition: diet does not meet the recommendations of the ESC-guidelines), active smoking and regular alcohol abuse (definition: alcohol at least 4 days per week).

Results

366 patients with MI (55.8 ± 9.7 years old, 79.6% male) in the years before COVID-19 pandemic were compared to 423 patients with MI (57.6 ± 9.3 years old, 77.6% male) in the years during the pandemic. The rate of patients with physical inactivity (48.7% vs. 72.7%, p < 0.05) and unhealthy diet (49.0% vs. 63.7%, p < 0.05) increased significantly during the pandemic. In addition, a non-significant increase of active smoking (44.5% vs. 47.5%, p = n.s.) and regular alcohol consumption (23.5% vs. 27.2%, p = n.s.) was observed. Quality of life decreased significantly in the years during the pandemic compared to the years before the pandemic (EQ5D VAS: 67.5 ± 18.6 vs. 63.2 ± 21.6, p < 0.05).

Conclusion:

The rate of lifestyle-related risk factors in patients with MI increased during COVID-19 pandemic. There is an urgent need to enforce public efforts supporting healthy lifestyle (physical activity, healthy diet, smoking and alcohol prevention) to prevent a subsequent increase of cardiovascular diseases.