ST-segment elevation myocardial infarction: Management and association with prognosis during the COVID-19 pandemic in France.

6533b839fe1ef96bd12a66c3

RESEARCH PRODUCT

ST-segment elevation myocardial infarction: Management and association with prognosis during the COVID-19 pandemic in France.

Maxime Vignac Nicolas Meneveau Anne Sophie Martin Karl Isaaz Aurélie Manchuelle Laurent Bonello Fabien De Poli Mathieu Kerneis Thibault Pamart Michel Zeitouni Mathieu Becker Marie Robin Vassili Panagides Chekrallah Chamandi Cedric Yvorel Antoine Deney Loic Belle Michel Pansieri Karim Moussa Vincenzo Palermo Julien Adjedj Benjamin Duband Laura Cetran Flavien Vincent Carl Semaan Khalife Khalife Denis Angoulvant Benoit Lattuca S. Uhry Nicolas Riviere Madjid Boukantar Pascal Motreff Guillaume Cayla Pierluigi Lesizza Léa Juenin Nathalie Noirclerc Hakim Benamer Frédéric Bouisset Ashok Tirouvanziam Guillaume Bonnet Eric Van Belle

subject

Male MESH: Hyperlipidemias medicine.medical_treatment MESH: Comorbidity Comorbidity 030204 cardiovascular system & hematology MESH: Health Care Surveys MESH: Hypertension MESH: Procedures and Techniques Utilization 0302 clinical medicine Patient Admission Interquartile range MESH: Risk Factors Risk Factors ST segment MESH: COVID-19 030212 general & internal medicine Myocardial infarction Hospital Mortality MESH: Treatment Outcome education.field_of_study MESH: Middle Aged Cardiogenic shock Smoking MESH: Patient Acceptance of Health Care General Medicine MESH: Heart Rupture Post-Infarction Middle Aged Prognosis [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system Treatment Outcome Hypertension Cardiology Female Stents France Cardiology and Cardiovascular Medicine SCA ST+MESH: Percutaneous Coronary Intervention medicine.medical_specialty MESH: Pandemics MESH: Smoking MESH: Diabetes Mellitus Population Complications mécaniques Hyperlipidemias Revascularization MESH: Prognosis Time-to-Treatment STEMI 03 medical and health sciences Percutaneous Coronary Intervention [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system Internal medicine Lockdown medicine Diabetes Mellitus Humans MESH: SARS-CoV-2 MESH: Time-to-Treatment MESH: Hospital Mortality MESH: ST Elevation Myocardial Infarction education Pandemics Heart Rupture Post-Infarction MESH: Humans business.industry MESH: Patient Admission SARS-CoV-2 Percutaneous coronary intervention COVID-19 Patient Acceptance of Health Care medicine.disease Comorbidity MESH: Male MESH: France MESH: Stents [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie Health Care Surveys ST Elevation Myocardial Infarction [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie Mechanical complications business MESH: Female Procedures and Techniques Utilization Confinement

description

Systems of care have been challenged to control progression of the COVID-19 pandemic. Whether this has been associated with delayed reperfusion and worse outcomes in French patients with ST-segment elevation myocardial infarction (STEMI) is unknown.Aim: To compare the rate of STEMI admissions, treatment delays, and outcomes between the first peak of the COVID-19 pandemic in France and the equivalent period in 2019.Methods: In this nationwide French survey, data from consecutive STEMI patients from 65 centres referred for urgent revascularization between 1 March and 31 May 2020, and between 1 March and 31 May 2019, were analysed. The primary outcome was a composite of in-hospital death or non-fatal mechanical complications of acute myocardial infarction.Results: A total of 6306 patients were included. During the pandemic peak, a 13.9±6.6% (P=0.003) decrease in STEMI admissions per week was observed. Delays between symptom onset and percutaneous coronary intervention were longer in 2020 versus 2019 (270 [interquartile range 150-705] vs 245 [140-646]min; P=0.013), driven by the increase in time from symptom onset to first medical contact (121 [60-360] vs 150 [62-420]min; P=0.002). During 2020, a greater number of mechanical complications was observed (0.9% vs 1.7%; P=0.029) leading to a significant difference in the primary outcome (112 patients [5.6%] in 2019 vs 129 [7.6%] in 2020; P=0.018). No significant difference was observed in rates of orotracheal intubation, in-hospital cardiac arrest, ventricular arrhythmias and cardiogenic shock.Conclusions: During the first peak of the COVID-19 pandemic in France, there was a decrease in STEMI admissions, associated with longer ischaemic time, exclusively driven by an increase in patient-related delays and an increase in mechanical complications. These findings suggest the need to encourage the population to seek medical help in case of symptoms.

year	journal	country	edition	language
2021-05-01	Archives of cardiovascular diseases

10.1016/j.acvd.2021.01.005 https://pubmed.ncbi.nlm.nih.gov/33926830