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. (Primary Angioplasty for STEMI During COVID-19 Pandemic [ISACS-STEMI COVID-19] Registry; NCT04412655).
Impact of COVID-19 Pandemic on Mechanical Reperfusion for Patients With STEMI / 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.; Berg, J. T.; Laine, M.; Dirksen, M.; Siviglia, M.; Casella, G.; Kala, P.; Diez Gil, J. L.; 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.; Bosa Ojeda, F.; Lehtola, H.; Camacho-Freiere, S.; Kraaijeveld, A.; Antti, Y.; Boccalatte, M.; Deharo, P.; Martinez-Luengas, I. L.; Scheller, B.; Alexopulos, D.; Moreno, R.; Kedhi, E.; Uccello, G.; Faurie, B.; Gutierrez Barrios, A.; Di Uccio, F. S.; Wilbert, B.; Smits, P.; Cortese, G.; Parodi, G.; Dudek, D.. - In: JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY. - ISSN 0735-1097. - 76:20(2020), pp. 2321-2330. [10.1016/j.jacc.2020.09.546]
Impact of COVID-19 Pandemic on Mechanical Reperfusion for Patients With STEMI
De Luca G.
;Parodi G.;
2020-01-01
Abstract
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. (Primary Angioplasty for STEMI During COVID-19 Pandemic [ISACS-STEMI COVID-19] Registry; NCT04412655).I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
