Impact of COVID-19 pandemic on STEMI undergoing primary PCI treatment in Beijing, China - 11/02/22
Abstract |
Objective |
Strict control measures under the COVID epidemic have brought an inevitable impact on ST-segment elevation myocardial infarction (STEMI)’s emergency treatment. We investigated the impact of the COVID on the treatment of patients with STEMI undergoing primary PCI.
Methods |
In this single center cohort study, we selected a time frame of 6 month after declaration of COVID-19 infection (Jan 24-July 24, 2020); a group of STEMI patients in the same period of 2019 was used as control. Finally, a total of 246 STEMI patients, who were underwent primary PCI, were enrolled into the study (136 non COVID-19 outbreak periods and 110 COVID-19 outbreak periods). The impact of COVID on the time of symptom onset to the first medical contact (symptom-to-FMC) and door to balloon (D-to-B) was investigated. Moreover, the primary outcome was in-hospital major adverse cardiac events (MACE), defined as a composite of cardiac death, heart failure and malignant arrhythmia.
Results |
Compared with the same period in 2019, there was a 19% decrease in the total number of STEMI patients undergoing primary PCI at the peak of the pandemic in 2020. The delay in symptom-to-FMC was significantly longer in COVID Outbreak period (180 [68.75, 342] vs 120 [60,240] min, P = 0.003), and the D-to-B times increased significantly (148 [115–190] vs 84 [70–120] min, P < 0.001). However, among patients with STEMI, MACE was similar in both time periods (18.3% vs 25.7%, p = 0.168). On multivariable analysis, COVID was not independently associated with MACE; the history of diabetes, left main disease and age>65 years were the strongest predictors of MACE in the overall population.
Conclusions |
The COVID pandemic was not independently associated with MACE; suggesting that active primary PCI treatment preserved high-quality standards even when challenged by a severe epidemic.
Clinical trial registration: URL: ClinicalTrials.gov Unique identifier: NCT04427735.
Le texte complet de cet article est disponible en PDF.Keywords : STEMI, Primary PCI, COVID-19, Door-to-balloon, Symptom-to-FMC, MACE
Abbreviations : STEMI, COVID, PCI, MACE, HF, HCWs, cTnI, cTnT, CK-MB, NT-proBNP, D-to-B, symptom-to-FMC
Plan
Vol 53
P. 68-72 - mars 2022 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.