Impact of COVID-19 pandemic on STEMI care: An expanded analysis from the United States.
Angioplasty, Balloon, Coronary
/ statistics & numerical data
COVID-19
/ epidemiology
Comorbidity
Female
Follow-Up Studies
Humans
Male
Pandemics
Percutaneous Coronary Intervention
/ statistics & numerical data
Registries
Retrospective Studies
SARS-CoV-2
ST Elevation Myocardial Infarction
/ epidemiology
Time Factors
United States
/ epidemiology
COVID-19
ST-elevation myocardial infarction
STEMI
Journal
Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
ISSN: 1522-726X
Titre abrégé: Catheter Cardiovasc Interv
Pays: United States
ID NLM: 100884139
Informations de publication
Date de publication:
01 08 2021
01 08 2021
Historique:
revised:
05
07
2020
received:
18
06
2020
accepted:
06
07
2020
pubmed:
9
8
2020
medline:
19
8
2021
entrez:
9
8
2020
Statut:
ppublish
Résumé
To evaluate the impact of COVID-19 pandemic migitation measures on of ST-elevation myocardial infarction (STEMI) care. We previously reported a 38% decline in cardiac catheterization activations during the early phase of the COVID-19 pandemic mitigation measures. This study extends our early observations using a larger sample of STEMI programs representative of different US regions with the inclusion of more contemporary data. Data from 18 hospitals or healthcare systems in the US from January 2019 to April 2020 were collecting including number activations for STEMI, the number of activations leading to angiography and primary percutaneous coronary intervention (PPCI), and average door to balloon (D2B) times. Two periods, January 2019-February 2020 and March-April 2020, were defined to represent periods before (BC) and after (AC) initiation of pandemic mitigation measures, respectively. A generalized estimating equations approach was used to estimate the change in response variables at AC from BC. Compared to BC, the AC period was characterized by a marked reduction in the number of activations for STEMI (29%, 95% CI:18-38, p < .001), number of activations leading to angiography (34%, 95% CI: 12-50, p = .005) and number of activations leading to PPCI (20%, 95% CI: 11-27, p < .001). A decline in STEMI activations drove the reductions in angiography and PPCI volumes. Relative to BC, the D2B times in the AC period increased on average by 20%, 95%CI (-0.2 to 44, p = .05). The COVID-19 Pandemic has adversely affected many aspects of STEMI care, including timely access to the cardiac catheterization laboratory for PPCI.
Sections du résumé
OBJECTIVE
To evaluate the impact of COVID-19 pandemic migitation measures on of ST-elevation myocardial infarction (STEMI) care.
BACKGROUND
We previously reported a 38% decline in cardiac catheterization activations during the early phase of the COVID-19 pandemic mitigation measures. This study extends our early observations using a larger sample of STEMI programs representative of different US regions with the inclusion of more contemporary data.
METHODS
Data from 18 hospitals or healthcare systems in the US from January 2019 to April 2020 were collecting including number activations for STEMI, the number of activations leading to angiography and primary percutaneous coronary intervention (PPCI), and average door to balloon (D2B) times. Two periods, January 2019-February 2020 and March-April 2020, were defined to represent periods before (BC) and after (AC) initiation of pandemic mitigation measures, respectively. A generalized estimating equations approach was used to estimate the change in response variables at AC from BC.
RESULTS
Compared to BC, the AC period was characterized by a marked reduction in the number of activations for STEMI (29%, 95% CI:18-38, p < .001), number of activations leading to angiography (34%, 95% CI: 12-50, p = .005) and number of activations leading to PPCI (20%, 95% CI: 11-27, p < .001). A decline in STEMI activations drove the reductions in angiography and PPCI volumes. Relative to BC, the D2B times in the AC period increased on average by 20%, 95%CI (-0.2 to 44, p = .05).
CONCLUSIONS
The COVID-19 Pandemic has adversely affected many aspects of STEMI care, including timely access to the cardiac catheterization laboratory for PPCI.
Identifiants
pubmed: 32767652
doi: 10.1002/ccd.29154
pmc: PMC7436427
doi:
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
217-222Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2020 Wiley Periodicals LLC.
Références
N Engl J Med. 2020 Jul 2;383(1):88-89
pubmed: 32343497
Circulation. 2020 Jun 23;141(25):2113-2116
pubmed: 32352306
J Am Coll Cardiol. 2020 Sep 15;76(11):1375-1384
pubmed: 32330544
N Engl J Med. 2020 Jun 18;382(25):2478-2480
pubmed: 32302081
N Engl J Med. 2020 May 14;382(20):e61
pubmed: 32343498
J Am Coll Cardiol. 2020 Jun 9;75(22):2871-2872
pubmed: 32283124
Catheter Cardiovasc Interv. 2021 Aug 1;98(2):217-222
pubmed: 32767652
Circulation. 2020 Jun 16;141(24):1948-1950
pubmed: 32282225
Lancet Public Health. 2020 Aug;5(8):e437-e443
pubmed: 32473113
Catheter Cardiovasc Interv. 2020 Sep 1;96(3):586-597
pubmed: 32212409
N Engl J Med. 2020 Jul 23;383(4):400-401
pubmed: 32383831
Eur Heart J. 2020 Jun 7;41(22):2083-2088
pubmed: 32412631