COVID-19 pandemic, mechanical reperfusion and 30-day mortality in ST elevation myocardial infarction
Por:
De Luca, G, Algowhary, M, Uguz, B, Oliveira, DC, Ganyukov, V, Zimbakov, Z, Cercek, M, Jensen, LO, Loh, PH, Calmac, L, Roura-Ferrer, G, Quadros, A, Milewski, M, di Uccio, FS, von Birgelen, C, Versaci, F, Ten Berg, J, Casella, G, Wong, ASL, Kala, P, Gil, JLD, Carrillo, X, Dirksen, MT, Becerra-Munoz, VM, Lee, MKY, Juzar, DA, Joaquim, RD, Paladino, R, Milicic, D, Davlouros, P, Bakraceski, N, Zilio, F, Donazzan, L, Kraaijeveld, AO, Galasso, G, Lux, A, Marinucci, L, Guiducci, V, Menichelli, M, Scoccia, A, Yamac, A, Mert, KU, Rios, XF, Kovarnik, T, Kidawa, M, Moreu, J, Flavien, V, Fabris, E, Martinez-Luengas, IL, Boccalatte, M, Ojeda, FB, Arellano-Serrano, C, Caiazzo, G, Cirrincione, G, Kao, HL, Fores, JS, Vignali, L, Pereira, H, Manzo-Silberman, S, Ordonez, S, Ozkan, AA, Scheller, B, Lehtola, H, Teles, R, Mantis, C, Ylitalo, A, Silveira, JAB, Zoni, R, Bessonov, I, Savonitto, S, Kochiadakis, G, Alexopoulos, D, Uribe, C, Kanakakis, J, Faurie, B, Gabrielli, G, Gutierrez, A, Bachini, JP, Rocha, A, Tam, FCC, Rodriguez, A, Lukito, A, Saint-Joy, V, Pessah, G, Tuccillo, B, Cortese, G, Parodi, G, Bouraghda, MA, Kedhi, E, Lamelas, P, Suryapranata, H, Nardin, M and Verdoia, M
Publicada:
1 mar 2022
Ahead of Print:
1 oct 2021
Resumen:
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 doorto-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.
Filiaciones:
De Luca, G:
Eastern Piedmont Univ, Dept Cardiol, AOU Maggiore Carita, Novara, Italy
Eastern Piedmont Univ, Dept Translat Med, Novara, Italy
Algowhary, M:
Assiut Univ, Div Cardiol, Assiut, Egypt
Uguz, B:
Bursa City Hosp, Div Cardiol, Bursa, Turkey
Oliveira, DC:
Ctr PROCAPE Prof Tavares, Pronto Socorro Cardiol, Recife, PE, Brazil
Ganyukov, V:
Kemerovo Cardiol Ctr, Dept Heart & Vasc Surg, Kemerovo, Russia
Zimbakov, Z:
Ss Cyril & Methodius Univ Skopje, Univ Clin Cardiol, Skopje, North Macedonia
Cercek, M:
Univ Med Ctr, Ctr Intens Internal Med, Ljubljana, Slovenia
Jensen, LO:
Odense Univ Hosp, Div Cardiol, Odense, Denmark
Loh, PH:
Singapore Hlth Serv, Dept Cardiol, Singapore, Singapore
Calmac, L:
Univ Bucharest, Clin Emergency Hosp, Bucuresti, Bucharest, Romania
Roura-Ferrer, G:
Bellvitge Univ Hosp, Intervent Cardiol Unit, Lhospitalet De Llobregat, Spain
Quadros, A:
Inst Cardiol, Rio Grande do Sul State Dept Hlth, Porto Alegre, RS, Brazil
Milewski, M:
Med Univ Silesia, Div Cardiol, Katowice, Poland
di Uccio, FS:
Osped Mare, Div Cardiol, Naples, Italy
von Birgelen, C:
Acad Med Ctr, Thoraxctr Twente, Dept Cardiol, Med Spectrum Twente, Twente, Netherlands
Versaci, F:
S Maria Goretti Hosp, Dept Cardiol, Latina, Italy
Ten Berg, J:
Sint Antonius Ziekenhuis, Dept Cardiol, Nieuwegein, Netherlands
Casella, G:
Osped Maggiore Bologna, Cardiol, Bologna, Italy
Wong, ASL:
Natl Heart Ctr Singapore, Cardiol, Singapore, Singapore
Kala, P:
Masaryk Univ, Univ Hosp Brno, Brno, Czech Republic
Gil, JLD:
Hosp Univ & Politecn La Fe, Dept Cardiol, Valencia, Spain
:
Hosp Badalona Germans Trias & Pujol, Dept Cardiol, Badalona, Spain
Dirksen, MT:
Med Ctr Alkmaar, Cardiol, Alkmaar, Netherlands
Becerra-Munoz, VM:
Univ Hosp Virgen de la Victoria, Dept Cardiol, Malaga, Spain
Lee, MKY:
Queen Elizabeth Hosp Univ Hong Kong, Dept Cardiol, Hong Kong, Peoples R China
Juzar, DA:
Natl Cardiovasc Ctr Harapan Kita, Dept Cardiol & Vasc Med, Jakarta, Indonesia
Joaquim, RD:
Santa Catarina Praia Comprida, Inst Cardiol, Sao Jose, Brazil
Paladino, R:
Villa Fiori Srl, Div Cardiol, Acerra, Italy
Milicic, D:
Univ Zagreb, Dept Cardiol, Zagreb, Croatia
Davlouros, P:
Univ Patras, Dept Cardiol, Patras, Greece
Bakraceski, N:
Ohrid Univ Hosp, Ctr Cardiovasc Dis, Ohrid, North Macedonia
Zilio, F:
Osped Santa Chiara Trento, Div Cardiol, Trento, Italy
Donazzan, L:
Osped Bolzano, Cardiol, Bolzano, Italy
Kraaijeveld, AO:
Univ Utrecht, Div Cardiol, Utrecht, Netherlands
Galasso, G:
Univ Salerno, Div Cardiol, Salerno, Italy
Lux, A:
Maastricht Univ Hosp, Cardiol, Maastricht, Netherlands
Marinucci, L:
Azienda Osped Osped Riuniti Marche Nord, Div Cardiol, Ancona, Italy
Guiducci, V:
ASL 3 Reggio Emilia, Div Cardiol, Reggio Emilia, Italy
Menichelli, M:
Osped Fabrizio Spaziani, Cardiol Div, Rome, Italy
Osped F Spaziani, Cardiol Div, Frosinone, Italy
Scoccia, A:
Osped S Anna Ferrara, Div Cardiol, Ferrara, Italy
Yamac, A:
Bezmialem Vakif Univ Stanbul, Dept Cardiol, Istanbul, Turkey
Mert, KU:
Eskisehir Osmangazi Univ, Div Cardiol, Eskisehir, Turkey
Rios, XF:
Complexo Hosp Univ, La Coruna, Spain
Kovarnik, T:
Univ Hosp Prague, Dept Cardiovasc Med, Prague, Czech Republic
Kidawa, M:
Med Univ Lodz, Cent Hosp, Lodz, Poland
Moreu, J:
Hosp Complex Toledo, Div Cardiol, Toledo, Spain
Flavien, V:
Lille Univ Hosp Ctr, Div Cardiol, Lille, France
Fabris, E:
Univ Trieste, Dept Cardiol, Dipartimento Sci Med Chirurg & Salute, Trieste, Italy
Martinez-Luengas, IL:
Hosp Cabuenes, Div Cardiol, Gijon, Spain
Boccalatte, M:
Osped Santa Maria delle Grazie, Div Cardiol, Naples, Italy
Ojeda, FB:
Consorcio Sanitario de Tenerife, Div Cardiol, Santa Cruz De Tenerife, Spain
Arellano-Serrano, C:
Hosp Puerta Hierro de Mahadahonda, Div Cardiol, Barcelona, Spain
Caiazzo, G:
Osped G Moscati, Div Cardiol, Aversa, Aversa, Italy
Cirrincione, G:
Osped Civ Arnas, Div Cardiol, Palermo, Italy
Kao, HL:
Natl Taiwan Univ Hosp, Dept Internal Med, Cardiol Div, Taipei, Taiwan
Fores, JS:
Univ Valencia, Hosp Clin Univ, Dept Cardiol, Valencia, Spain
Vignali, L:
Azienda Osped Sanitaria, Intervent Cardiol Unit, Parma, Italy
Pereira, H:
Garcia de Orta Hosp, Cardiol Dept, Almada, Portugal
Manzo-Silberman, S:
Dept Cardiol, INSERM Delegat Reg Paris 7, Bagnolet, France
Ordonez, S:
Inst Cardiovasc Buenos Aires, Buenos Aires, DF, Argentina
Ozkan, AA:
Istanbul Univ, Cardiol Inst, Istanbul, Turkey
Scheller, B:
Saarland Univ, Clin & Expt Intervent Cardiol, Saarbrucken, Germany
Lehtola, H:
Oulu Univ Hosp, Div Cardiol, Oulu, Finland
Teles, R:
Hosp Santa Cruz, CHLO Nova Med Sch, Dept Cardiol, CEDOC, Carnaxide, Portugal
Mantis, C:
Kontantopoul Hosp, Div Cardiol, Athens, Greece
Ylitalo, A:
Heart Ctr Turku, Div Cardiol, Turku, Finland
Silveira, JAB:
Hosp Santo Antonio, Div Cardiol, Porto, Portugal
Zoni, R:
Inst Cardiol Corrientes Juana Francisca Cabral, Corrientes, Argentina
Bessonov, I:
Tyumen Res Ctr, Cardiol, Tyumen, Russia
Savonitto, S:
Osped Alessandro Manzoni, Cardiol, Lecce, Italy
Kochiadakis, G:
Iraklion Univ Hosp, Div Cardiol, Iraklion, Greece
Alexopoulos, D:
Attikon Clin, Div Cardiol, Athens, Greece
Uribe, C:
Medellin Clin Univ UPB, Div Cardiol, Medellin, Colombia
Kanakakis, J:
Gen Hosp Athens Alexandra, Div Cardiol, Athens, Greece
Faurie, B:
Grp Hosp Mutualiste Grenoble, Div Cardiol, Grenoble, France
Gabrielli, G:
Azienda Osped Riuniti Presidio GM Lancisi, SOD Cardiol Emodinam UTIC, Ancona, Italy
Gutierrez, A:
Hosp Univ Puerta del Mar, Serv Cardiol, Cadiz, Spain
Bachini, JP:
Inst Cardiol Integral, Montevideo, Uruguay
Rocha, A:
Inst Nacl Cirug Cardiaca, Dept Cardiol & Cardiovasc Intervent, Montevideo, Uruguay
Tam, FCC:
Queen Mary Hosp, Dept Cardiol, Hong Kong, Peoples R China
Rodriguez, A:
Otamendi Hosp, Dept Cardiol, Buenos Aires, DF, Argentina
Lukito, A:
Pelita Harapan Univ, Cardiovasc Dept, Tangerang, Indonesia
Saint-Joy, V:
Ctr Hosp Antibes Juan Les Pins, Antibes, France
Pessah, G:
Cordoba Hosp, Div Cardiol, Cordoba, Argentina
Tuccillo, B:
Osped Mare, Div Cardiol, Naples, Italy
Cortese, G:
Univ Padua, Dept Stat Sci, Padua, Italy
Parodi, G:
Sassari Univ Hosp, Div Cardiol, Sassari, Italy
Bouraghda, MA:
Blida Univ Hosp, Div Cardiol, Blida, Algeria
Kedhi, E:
Univ Libre Bruxelles, Hop Erasmus, Cardiol, Brussels, Belgium
Lamelas, P:
Inst Cardiovasc Buenos Aires, Buenos Aires, DF, Argentina
Suryapranata, H:
Radboud UMC, Cardiol, Nijmegen, Netherlands
Nardin, M:
Eastern Piedmont Univ, Dept Translat Med, Novara, Italy
Osped Riuniti, Brescia, Italy
Verdoia, M:
Eastern Piedmont Univ, Dept Translat Med, Novara, Italy
Nuovo Osped Infermi ASL Biella, Cardiol, Biella, Italy
Green Published, Bronze
|