Publication details

Impact of COVID-19 Pandemic on Mechanical Reperfusion for Patients With STEMI

Authors	DE LUCA G. VERDOIA M. CERCEK M. JENSEN L. O. VAVLUKIS M. CALMAC L. JOHNSON T. FERRER G. R. GANYUKOV V. WOJAKOWSKI W. KINNAIRD T. VAN BIRGELEN C. COTTIN Y. IJSSELMUIDEN A. TUCCILLO B. VERSACI F. ROYAARDS K. J . TEN BERG J. LAINE M. DIRKSEN M. SIVIGLIA M. CASELLA G. KALA Petr GIL J. L. D. BANNING A. BECERRA V. DE SIMONE C. SANTUCCI A. CARRILLO X. SCOCCIA A. AMOROSO G. LUX A. KOVARNIK T. DAVLOUROS P. MEHILLI J. GABRIELLI G. RIOS X. F. BAKRACESKI N. LEVESQUE S. CIRRINCIONE G. GUIDUCCI V. KIDAWA M. SPEDICATO L. MARINUCCI L. LUDMAN P. ZILIO F. GALASSO G. FABRIS E. MENICHELLI M. GARCIA-TOUCHARD A. MANZO S. CAIAZZO G. MOREU J. FORES J. S. DONAZZAN L. VIGNALI L. TELES R. BENIT E. AGOSTONI P. OJEDA F. B. LEHTOLA H. CAMACHO-FREIERE S. KRAAIJEVELD A. ANTTI Y. BOCCALATTE M. DEHARO P. MARTINEZ-LUENGAS I. L. SCHELLER B. ALEXOPOULOS D. MORENO R. KEDHI E. UCCELLO G. FAURIE B. BARRIOS A. G. DI UCCIO F. S. WILBERT B. SMITS P. CORTESE G. PARODI G. DUDEK D.
Year of publication	2020
Type	Article in Periodical
Magazine / Source	Journal of the American College of Cardiology
MU Faculty or unit	Faculty of Medicine
Citation
web	https://www.sciencedirect.com/science/article/pii/S0735109720372399?via%3Dihub
Doi	http://dx.doi.org/10.1016/j.jacc.2020.09.546
Keywords	COVID-19; primary angioplasty; STEMI
Description	BACKGROUND The fear of contagion during the coronavirus disease-2019 (COVID-19) pandemic may have potentially refrained patients with ST-segment elevation myocardial infarction (STEMI) from accessing the emergency system, with subsequent impact on mortality. OBJECTIVES The ISACS-STEMI COVID-19 registry aims to estimate the true impact of the COVID-19 pandemic on the treatment and outcome of patients with STEMI treated by primary percutaneous coronary intervention (PPCI), with identification of "at-risk" patient cohorts for failure to present or delays to treatment. METHODS This retrospective registry was performed in European high-volume PPCI centers and assessed patients with STEMI treated with PPPCI in March/April 2019 and 2020. Main outcomes are the incidences of PPCI, delayed treatment, and in-hospital mortality. RESULTS A total of 6,609 patients underwent PPCI in 77 centers, located in 18 countries. In 2020, during the pandemic, there was a significant reduction in PPCI as compared with 2019 (incidence rate ratio: 0.811; 95% confidence interval: 0.78 to 0.84; p < 0.0001). The heterogeneity among centers was not related to the incidence of death due to COVID-19. A significant interaction was observed for patients with arterial hypertension, who were less frequently admitted in 2020 than in 2019. Furthermore, the pandemic was associated with a significant increase in door-to-balloon and total ischemia times, which may have contributed to the higher mortality during the pandemic. CONCLUSIONS The COVID-19 pandemic had significant impact on the treatment of patients with STEMI, with a 19% reduction in PPCI procedures, especially among patients suffering from hypertension, and a longer delay to treatment, which may have contributed to the increased mortality during the pandemic. (C) 2020 by the American College of Cardiology Foundation.