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Impact of COVID-19 Pandemic on Mechanical Reperfusion for Patients With STEMI #MMPMID33183506
De Luca G; Verdoia M; Cercek M; Jensen LO; Vavlukis M; Calmac L; Johnson T; Ferrer GR; Ganyukov V; Wojakowski W; Kinnaird T; van Birgelen C; Cottin Y; IJsselmuiden A; Tuccillo B; Versaci F; Royaards KJ; Berg JT; Laine M; Dirksen M; Siviglia M; Casella G; Kala P; Diez Gil JL; 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 XF; 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 JS; 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 IL; Scheller B; Alexopoulos D; Moreno R; Kedhi E; Uccello G; Faurie B; Gutierrez Barrios A; Di Uccio FS; Wilbert B; Smits P; Cortese G; Parodi G; Dudek D
J Am Coll Cardiol 2020[Nov]; 76 (20): 2321-2330 PMID33183506show ga
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).
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J+Am+Coll+Cardiol 2020 ; 76 (20): 2321-2330
