COVID-19 pandemic, mechanical reperfusion and 30-day mortality in ST elevation myocardial infarction. Issue 6 (28th October 2021)

• Record Type: Journal Article
• Authors: 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; Bosa Ojeda, Francisco; Arellano-Serrano, Carlos; Caiazzo, Gianluca; Cirrincione, Giuseppe; Kao, Hsien-Li; Sanchis Fores, Juan; Vignali, Luigi; Pereira, Helder; Manzo-Silberman, Stéphane; Ordonez, Santiago; Özkan, Alev Arat; Scheller, Bruno; Lehtola, Heidi; Teles, Rui; Mantis, Christos; Ylitalo, Antti; Brum Silveira, Joao Antonio; Zoni, Rodrigo; Bessonov, Ivan; Savonitto, Stefano; Kochiadakis, George; Alexopoulos, Dimitrios; Uribe, Carlos; Kanakakis, John; Faurie, Benjamin; Gabrielli, Gabriele; Gutiérrez, Alejandro; Bachini, Juan Pablo; Rocha, Alex; Tam, Franckie CC; Rodriguez, Alfredo; Lukito, Antonia; Saint-Joy, Veauthyelau; Pessah, Gustavo; Tuccillo, Bernardino; Cortese, Giuliana; Parodi, Guido; Bouraghda, Mohamed Abed; Kedhi, Elvin; Lamelas, Pablo; Suryapranata, Harry; Nardin, Matteo; Verdoia, Monica;
• Other Names: author non-byline.; Johnson Tom author non-byline.; Kinnaird Tim author non-byline.; Cottin Yves author non-byline.; Ijsselmuiden Alexander author non-byline.; Royaards Kees-Jan author non-byline.; Siviglia Massimo author non-byline.; Amoroso Giovanni author non-byline.; Banning Adrian author non-byline.; Santucci Andrea author non-byline.; Spedicato Leonardo author non-byline.; Mehilli Julinda author non-byline.; Levesque Sébastien author non-byline.; Ludman Peter author non-byline.; Deharo Pierre author non-byline.; Benit Edouard author non-byline.; Agostoni Pierfrancesco author non-byline.; Camacho-Freiere Santiago author non-byline.; Brouwer Marc author non-byline.; Camaro Cyril author non-byline.; Wilbert Bor author non-byline.; Smits Pieter author non-byline.; Laine Mike author non-byline.; Moreno Raul author non-byline.
• Is Part Of: Heart. Volume 108:Issue 6(2022)
• Page Start: 458
• Page End: 466
• Publication Date: 2021-10-28
• Subjects: COVID-19 -- myocardial infarction -- percutaneous coronary intervention; Heart -- Diseases -- Treatment -- Periodicals; Cardiology -- Periodicals; 616.12
• DOI: 10.1136/heartjnl-2021-319750
• Languages: English
• ISSNs: 1355-6037

Abstract

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 .