6533b7dafe1ef96bd126d9a2
RESEARCH PRODUCT
COVID-19 pandemic, mechanical reperfusion and 30-day mortality in ST elevation myocardial infarction
De Luca GAlgowhary MUguz BOliveira DcGanyukov VZimbakov ZCercek MJensen LoLoh PhCalmac LRoura-ferrer GQuadros AMilewski MScotto Di Uccio FVon Birgelen CVersaci FTen Berg JCasella GWong AslKala PDiez Gil JlCarrillo XDirksen MtBecerra-muñoz VmKang-yin Lee MJuzar DaDe Moura Joaquim RPaladino RMilicic DDavlouros PBakraceski NZilio FDonazzan LKraaijeveld AoGalasso GLux AMarinucci LGuiducci VMenichelli MScoccia AYamac AUgur Mert KFlores Rios XKovarnik TKidawa MMoreu JFlavien VFabris ELozano Martìnez-luengas IBoccalatte MBosa Ojeda FArellano-serrano CCaiazzo GCirrincione GKao HlSanchis Fores JVignali LPereira HManzo-silberman SOrdonez SÖZkan AaScheller BLehtola HTeles RMantis CYlitalo ABrum Silveira JaZoni RBessonov ISavonitto SKochiadakis GAlexopoulos DUribe CKanakakis JFaurie BGabrielli GGutiérrez ABachini JpRocha ATam FcRodriguez ALukito ASaint-joy VPessah GTuccillo BCortese GParodi GBouraghda MaKedhi ELamelas PSuryapranata HNardin MVerdoia MIsacs-stemi Covid-19Collaboratorssubject
RegistrieMaleST Elevation Myocardial Infarction/diagnosisTime FactorsPercutaneousmedicine.medical_treatmentVascular damage Radboud Institute for Health Sciences [Radboudumc 16]Coronary Artery DiseasePractice Patterns030204 cardiovascular system & hematologyRate ratioTime-to-Treatment/trendsCardiologists0302 clinical medicineRetrospective StudieHeart RateRisk FactorsPandemicST segmentRegistriesHospital Mortality030212 general & internal medicineMyocardial infarctionPractice Patterns Physicians'10. No inequalityPercutaneous Coronary Intervention/adverse effectsHospital Mortality/trendsCOVID-19; myocardial infarction; percutaneous coronary interventionIncidenceIncidence (epidemiology)*percutaneous coronary interventionMiddle Aged3. Good healthTreatment Outcomemyocardial infarctionCardiologyFemale*COVID-19Cardiology and Cardiovascular MedicineCardiologists/trendsHumanCOVID-19; myocardial infarction; percutaneous coronary intervention; Aged; Cardiologists; Female; Hospital Mortality; Humans; Incidence; Male; Middle Aged; Percutaneous Coronary Intervention; Practice Patterns Physicians'; Registries; Retrospective Studies; Risk Assessment; Risk Factors; ST Elevation Myocardial Infarction; Time Factors; Time-to-Treatment; Treatment Outcome; COVID-19medicine.medical_specialtyTime FactorCoronavirus disease 2019 (COVID-19)CardiologistRisk AssessmentTime-to-Treatment03 medical and health sciencesInternal medicinemedicineHumansAcute Coronary SyndromePandemicsRetrospective StudiesAgedPhysicians'SARS-CoV-2business.industryRisk FactorCOVID-19 myocardial infarction percutaneous coronary interventionpercutaneous coronary interventionPercutaneous coronary interventionCOVID-19*myocardial infarctionmedicine.diseasePractice Patterns Physicians'/trendsST Elevation Myocardial Infarctionbusinessdescription
ObjectiveThe initial data of the International Study on Acute Coronary Syndromes - ST Elevation Myocardial Infarction COVID-19 showed in Europe a remarkable reduction in primary percutaneous coronary intervention procedures and higher in-hospital mortality during the initial phase of the pandemic as compared with the prepandemic period. The aim of the current study was to provide the final results of the registry, subsequently extended outside Europe with a larger inclusion period (up to June 2020) and longer follow-up (up to 30 days).MethodsThis is a retrospective multicentre registry in 109 high-volume primary percutaneous coronary intervention (PPCI) centres from Europe, Latin America, South-East Asia and North Africa, enrolling 16 674 patients with ST segment elevation myocardial infarction (STEMI) undergoing PPPCI in March/June 2019 and 2020. The main study outcomes were the incidence of PPCI, delayed treatment (ischaemia time >12 hours and door-to-balloon >30 min), in-hospital and 30-day mortality.ResultsIn 2020, during the pandemic, there was a significant reduction in PPCI as compared with 2019 (incidence rate ratio 0.843, 95% CI 0.825 to 0.861, p<0.0001). This reduction was significantly associated with age, being higher in older adults (>75 years) (p=0.015), and was not related to the peak of cases or deaths due to COVID-19. The heterogeneity among centres was high (p<0.001). Furthermore, the pandemic was associated with a significant increase in door-to-balloon time (40 (25–70) min vs 40 (25–64) min, p=0.01) and total ischaemia time (225 (135–410) min vs 196 (120–355) min, p<0.001), which may have contributed to the higher in-hospital (6.5% vs 5.3%, p<0.001) and 30-day (8% vs 6.5%, p=0.001) mortality observed during the pandemic.ConclusionPercutaneous revascularisation for STEMI was significantly affected by the COVID-19 pandemic, with a 16% reduction in PPCI procedures, especially among older patients (about 20%), and longer delays to treatment, which may have contributed to the increased in-hospital and 30-day mortality during the pandemic.Trial registration numberNCT04412655.
year | journal | country | edition | language |
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2022-03-01 |