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2020 ; 41
(19
): 1839-1851
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EAPCI Position Statement on Invasive Management of Acute Coronary Syndromes
during the COVID-19 pandemic
#MMPMID32405641
Chieffo A
; Stefanini GG
; Price S
; Barbato E
; Tarantini G
; Karam N
; Moreno R
; Buchanan GL
; Gilard M
; Halvorsen S
; Huber K
; James S
; Neumann FJ
; Möllmann H
; Roffi M
; Tavazzi G
; Mauri Ferré J
; Windecker S
; Dudek D
; Baumbach A
Eur Heart J
2020[May]; 41
(19
): 1839-1851
PMID32405641
show ga
The coronavirus disease 2019 (COVID-19) pandemic poses an unprecedented challenge
to healthcare worldwide. The infection can be life threatening and require
intensive care treatment. The transmission of the disease poses a risk to both
patients and healthcare workers. The number of patients requiring hospital
admission and intensive care may overwhelm health systems and negatively affect
standard care for patients presenting with conditions needing emergency
interventions. This position statements aims to assist cardiologists in the
invasive management of acute coronary syndrome (ACS) patients in the context of
the COVID-19 pandemic. To that end, we assembled a panel of interventional
cardiologists and acute cardiac care specialists appointed by the European
Association of Percutaneous Cardiovascular Interventions (EAPCI) and from the
Acute Cardiovascular Care Association (ACVC) and included the experience from the
first and worst affected areas in Europe. Modified diagnostic and treatment
algorithms are proposed to adapt evidence-based protocols for this unprecedented
challenge. Various clinical scenarios, as well as management algorithms for
patients with a diagnosed or suspected COVID-19 infection, presenting with ST-
and non-ST-segment elevation ACS are described. In addition, we address the need
for re-organization of ACS networks, with redistribution of hub and spoke
hospitals, as well as for in-hospital reorganization of emergency rooms and
cardiac units, with examples coming from multiple European countries.
Furthermore, we provide a guidance to reorganization of catheterization
laboratories and, importantly, measures for protection of healthcare providers
involved with invasive procedures.
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