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COVID-19 pandemic, mechanical reperfusion and 30-day mortality in ST elevation myocardial infarction.
De Luca, Giuseppe; Algowhary, Magdy; Uguz, Berat; Oliveira, Dinaldo C; Ganyukov, Vladimir; Zimbakov, Zan; Cercek, Miha; Jensen, Lisette Okkels; Loh, Poay Huan; Calmac, Lucian; Roura-Ferrer, Gerard; Quadros, Alexandre; Milewski, Marek; Scotto di Uccio, Fortunato; von Birgelen, Clemens; Versaci, Francesco; Ten Berg, Jurriën; Casella, Gianni; Wong, Aaron Sung Lung; Kala, Petr; Diez Gil, Jose Luis; Carrillo, Xavier; Dirksen, Maurits Theodoor; Becerra-Muñoz, Víctor Manuel; Kang-Yin Lee, Michael; Juzar, Dafsah A; de Moura Joaquim, Rodrigo; Paladino, Roberto; Milicic, Davor; Davlouros, Periklis; Bakraceski, Nikola; Zilio, Filippo; Donazzan, Luca; Kraaijeveld, Adriaan O; Galasso, Gennaro; Lux, Arpad; Marinucci, Lucia; Guiducci, Vincenzo; Menichelli, Maurizio; Scoccia, Alessandra; Yamac, Aylin; Ugur Mert, Kadir; Flores Rios, Xacobe; Kovarnik, Tomas; Kidawa, Michal; Moreu, Jose; Flavien, Vincent; Fabris, Enrico; Lozano Martìnez-Luengas, Iñigo; Boccalatte, Marco.
  • De Luca G; Department of Cardiology, AOU Maggiore della Carità, Eastern Piedmont University, Novara, Italy giuseppe.deluca@med.uniupo.it.
  • Algowhary M; Department of Translational Medicine, Eastern Piedmont University, Novara, Italy.
  • Uguz B; Division of Cardiology, Assiut University, Assiut, Egypt.
  • Oliveira DC; Division of Cardiology, Bursa City Hospital, Bursa, Turkey.
  • Ganyukov V; Pronto de Socorro Cardiologico, Centro PROCAPE Prof. Tavares, Recife, Brazil.
  • Zimbakov Z; Department of Heart and Vascular Surgery, Kemerovo Cardiology Center, Кемерово, Russia.
  • Cercek M; University Clinic for Cardiology, Ss Cyril and Methodius University in Skopje, Skopje, Macedonia.
  • Jensen LO; Centre for Intensive Internal Medicine, University Medical Centre, Ljubljana, Slovenia.
  • Loh PH; Division of Cardiology, Odense Universitetshospital, Odense, Denmark.
  • Calmac L; Department of Cardiology, Singapore Health Service, Singapore.
  • Roura-Ferrer G; Clinic Emergency Hospital, University of Bucharest, Bucuresti, Romania.
  • Quadros A; Interventional Cardiology Unit, Bellvitge University Hospital, L'Hospitalet de Llobregat, Spain.
  • Milewski M; Instituto de Cardiologia, Rio Grande do Sul State Department of Health, Porto Alegre, Brazil.
  • Scotto di Uccio F; Division of Cardiology, Medical University of Silesia in Katowice, Katowice, Poland.
  • von Birgelen C; Division of Cardiology, Ospedale del Mare, Napoli, Italy.
  • Versaci F; Department of Cardiology, Thoraxcentrum Twente, Medisch Spectrum Twente, Academisch Medisch Centrum, Twente, The Netherlands.
  • Ten Berg J; Department of Cardiology, S Maria Goretti Hospital, Latina, Italy.
  • Casella G; Department of Cardiology, Sint Antonius Ziekenhuis, Nieuwegein, The Netherlands.
  • Wong ASL; Cardiology, Ospedale Maggiore Bologna, Bologna, Italy.
  • Kala P; Cardiology, National Heart Centre Singapore, Singapore.
  • Diez Gil JL; University Hospital Brno, Masaryk University, Brno, Czech Republic.
  • Carrillo X; Department of Cardiology, Hospital Universitari i Politecnic La Fe, Valencia, Spain.
  • Dirksen MT; Department of Cardiology, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.
  • Becerra-Muñoz VM; Cardiology, Medical Centre Alkmaar, Alkmaar, The Netherlands.
  • Kang-Yin Lee M; Department of Cardiology, University Hospital Virgen de la Victoria, Malaga, Spain.
  • Juzar DA; Department of Cardiology, Queen ElizabethHospital University of Hong Kong, Hong Kong, Hong Kong.
  • de Moura Joaquim R; Department of cardiology and Vascular Medicine, National Cardiovascular Center 'Harapan Kita', Jakarta, Indonesia.
  • Paladino R; Instituto de Cardiologia, Santa Catarina Praia Comprida, Sao Jose, Brazil.
  • Milicic D; Division of Cardiology, Villa dei fiori Srl, Acerra, Italy.
  • Davlouros P; Department of Cardiology, University of Zagreb, Zagreb, Croatia.
  • Bakraceski N; Department of Cardiology, University of Patras, Patras, Greece.
  • Zilio F; Center for Cardiovascular Diseases, Ohrid University Hospital, Ohrid, Macedonia.
  • Donazzan L; Division of Cardiology, Ospedale Santa Chiara di Trento, Trento, Italy.
  • Kraaijeveld AO; Cardiology, Ospedale di Bolzano, Bolzano, Italy.
  • Galasso G; Division of Cardiology, Utrecht University, Utrecht, The Netherlands.
  • Lux A; Division of Cardiology, University of Salerno, Salerno, Italy.
  • Marinucci L; Cardiology, Maastricht University Hospital, Maastricht, The Netherlands.
  • Guiducci V; Division of Cardiology, Azienda Ospedaliera "Ospedali Riuniti Marche Nord", Ancona, Italy.
  • Menichelli M; Division of Cardiology, ASL 3 Reggio Emilia, Reggio Emilia, Italy.
  • Scoccia A; Cardiology Division, Ospedale Fabrizio Spaziani, Roma, Italy.
  • Yamac A; Cardiology Division, Ospedale "F. Spaziani", Frosinone, Italy.
  • Ugur Mert K; Division of Cardiology, Ospedale S. Anna Ferrara, Ferrara, Italy.
  • Flores Rios X; Department of Cardiology, Bezmialem Vakif University Istanbul, Istanbul, Turkey.
  • Kovarnik T; Division of Cardiology, Eskisehir Osmangazi Universitesi, Eskisehir, Turkey.
  • Kidawa M; Complexo Hospetaliero Universitario, La Coruna, La Coruna, Spain.
  • Moreu J; Department of Cardiovascular Medicine, University Hospital Prague, Prague, Czech Republic.
  • Flavien V; Central Hospital, Medical University of Lodz, Lodz, Poland.
  • Fabris E; Division of Cardiology, Hospital Complex of Toledo, Toledo, Spain.
  • Lozano Martìnez-Luengas I; Division of Cardiology, Lille University Hospital Center, Lille, France.
  • Boccalatte M; Department of Cardiology, Universita degli Studi di Trieste Dipartimento di Scienze Mediche Chirurgiche e della Salute, Trieste, Italy.
Heart ; 108(6): 458-466, 2022 03.
Article in English | MEDLINE | ID: covidwho-1495503
ABSTRACT

OBJECTIVE:

The 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).

METHODS:

This 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.

RESULTS:

In 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.

CONCLUSION:

Percutaneous 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 NUMBER NCT04412655.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Practice Patterns, Physicians&apos; / Time-to-Treatment / Percutaneous Coronary Intervention / ST Elevation Myocardial Infarction / Cardiologists / COVID-19 Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: Heart Journal subject: Cardiology Year: 2022 Document Type: Article Affiliation country: Heartjnl-2021-319750

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Practice Patterns, Physicians&apos; / Time-to-Treatment / Percutaneous Coronary Intervention / ST Elevation Myocardial Infarction / Cardiologists / COVID-19 Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Aged / Female / Humans / Male / Middle aged Language: English Journal: Heart Journal subject: Cardiology Year: 2022 Document Type: Article Affiliation country: Heartjnl-2021-319750