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Effect of the COVID-19 Pandemic on Treatment Delays in Patients with ST-Segment Elevation Myocardial Infarction

Coronavirus disease 19 (COVID-19) and its associated restrictions could affect ischemic times in patients with ST-segment elevation myocardial infarction (STEMI). The objective of this study was to investigate the influence of the COVID-19 outbreak on ischemic times in consecutive all-comer STEMI pa...

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Autores principales: Reinstadler, Sebastian J., Reindl, Martin, Lechner, Ivan, Holzknecht, Magdalena, Tiller, Christina, Roithinger, Franz Xaver, Frick, Matthias, Hoppe, Uta C., Jirak, Peter, Berger, Rudolf, Delle-Karth, Georg, Laßnig, Elisabeth, Klug, Gert, Bauer, Axel, Binder, Ronald, Metzler, Bernhard
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7408681/
https://www.ncbi.nlm.nih.gov/pubmed/32664309
http://dx.doi.org/10.3390/jcm9072183
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author Reinstadler, Sebastian J.
Reindl, Martin
Lechner, Ivan
Holzknecht, Magdalena
Tiller, Christina
Roithinger, Franz Xaver
Frick, Matthias
Hoppe, Uta C.
Jirak, Peter
Berger, Rudolf
Delle-Karth, Georg
Laßnig, Elisabeth
Klug, Gert
Bauer, Axel
Binder, Ronald
Metzler, Bernhard
author_facet Reinstadler, Sebastian J.
Reindl, Martin
Lechner, Ivan
Holzknecht, Magdalena
Tiller, Christina
Roithinger, Franz Xaver
Frick, Matthias
Hoppe, Uta C.
Jirak, Peter
Berger, Rudolf
Delle-Karth, Georg
Laßnig, Elisabeth
Klug, Gert
Bauer, Axel
Binder, Ronald
Metzler, Bernhard
author_sort Reinstadler, Sebastian J.
collection PubMed
description Coronavirus disease 19 (COVID-19) and its associated restrictions could affect ischemic times in patients with ST-segment elevation myocardial infarction (STEMI). The objective of this study was to investigate the influence of the COVID-19 outbreak on ischemic times in consecutive all-comer STEMI patients. We included consecutive STEMI patients (n = 163, median age: 61 years, 27% women) who were referred to seven tertiary care hospitals across Austria for primary percutaneous coronary intervention between 24 February 2020 (calendar week 9) and 5 April 2020 (calendar week 14). The number of patients, total ischemic times and door-to-balloon times in temporal relation to COVID-19-related restrictions and infection rates were analyzed. While rates of STEMI admissions decreased (calendar week 9/10 (n = 69, 42%); calendar week 11/12 (n = 51, 31%); calendar week 13/14 (n = 43, 26%)), total ischemic times increased from 164 (interquartile range (IQR): 107–281) min (calendar week 9/10) to 237 (IQR: 141–560) min (calendar week 11/12) and to 275 (IQR: 170–590) min (calendar week 13/14) (p = 0.006). Door-to-balloon times were constant (p = 0.60). There was a significant difference in post-interventional Thrombolysis in myocardial infarction (TIMI) flow grade 3 in patients treated during calendar week 9/10 (97%), 11/12 (84%) and 13/14 (81%; p = 0.02). Rates of in-hospital death and re-infarction were similar between groups (p = 0.48). Results were comparable when dichotomizing data on 10 March and 16 March 2020, when official restrictions were executed. In this cohort of all-comer STEMI patients, we observed a 1.7-fold increase in ischemic time during the outbreak of COVID-19 in Austria. Patient-related factors likely explain most of this increase. Counteractive steps are needed to prevent further cardiac collateral damage during the ongoing COVID-19 pandemic.
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spelling pubmed-74086812020-08-13 Effect of the COVID-19 Pandemic on Treatment Delays in Patients with ST-Segment Elevation Myocardial Infarction Reinstadler, Sebastian J. Reindl, Martin Lechner, Ivan Holzknecht, Magdalena Tiller, Christina Roithinger, Franz Xaver Frick, Matthias Hoppe, Uta C. Jirak, Peter Berger, Rudolf Delle-Karth, Georg Laßnig, Elisabeth Klug, Gert Bauer, Axel Binder, Ronald Metzler, Bernhard J Clin Med Article Coronavirus disease 19 (COVID-19) and its associated restrictions could affect ischemic times in patients with ST-segment elevation myocardial infarction (STEMI). The objective of this study was to investigate the influence of the COVID-19 outbreak on ischemic times in consecutive all-comer STEMI patients. We included consecutive STEMI patients (n = 163, median age: 61 years, 27% women) who were referred to seven tertiary care hospitals across Austria for primary percutaneous coronary intervention between 24 February 2020 (calendar week 9) and 5 April 2020 (calendar week 14). The number of patients, total ischemic times and door-to-balloon times in temporal relation to COVID-19-related restrictions and infection rates were analyzed. While rates of STEMI admissions decreased (calendar week 9/10 (n = 69, 42%); calendar week 11/12 (n = 51, 31%); calendar week 13/14 (n = 43, 26%)), total ischemic times increased from 164 (interquartile range (IQR): 107–281) min (calendar week 9/10) to 237 (IQR: 141–560) min (calendar week 11/12) and to 275 (IQR: 170–590) min (calendar week 13/14) (p = 0.006). Door-to-balloon times were constant (p = 0.60). There was a significant difference in post-interventional Thrombolysis in myocardial infarction (TIMI) flow grade 3 in patients treated during calendar week 9/10 (97%), 11/12 (84%) and 13/14 (81%; p = 0.02). Rates of in-hospital death and re-infarction were similar between groups (p = 0.48). Results were comparable when dichotomizing data on 10 March and 16 March 2020, when official restrictions were executed. In this cohort of all-comer STEMI patients, we observed a 1.7-fold increase in ischemic time during the outbreak of COVID-19 in Austria. Patient-related factors likely explain most of this increase. Counteractive steps are needed to prevent further cardiac collateral damage during the ongoing COVID-19 pandemic. MDPI 2020-07-10 /pmc/articles/PMC7408681/ /pubmed/32664309 http://dx.doi.org/10.3390/jcm9072183 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Reinstadler, Sebastian J.
Reindl, Martin
Lechner, Ivan
Holzknecht, Magdalena
Tiller, Christina
Roithinger, Franz Xaver
Frick, Matthias
Hoppe, Uta C.
Jirak, Peter
Berger, Rudolf
Delle-Karth, Georg
Laßnig, Elisabeth
Klug, Gert
Bauer, Axel
Binder, Ronald
Metzler, Bernhard
Effect of the COVID-19 Pandemic on Treatment Delays in Patients with ST-Segment Elevation Myocardial Infarction
title Effect of the COVID-19 Pandemic on Treatment Delays in Patients with ST-Segment Elevation Myocardial Infarction
title_full Effect of the COVID-19 Pandemic on Treatment Delays in Patients with ST-Segment Elevation Myocardial Infarction
title_fullStr Effect of the COVID-19 Pandemic on Treatment Delays in Patients with ST-Segment Elevation Myocardial Infarction
title_full_unstemmed Effect of the COVID-19 Pandemic on Treatment Delays in Patients with ST-Segment Elevation Myocardial Infarction
title_short Effect of the COVID-19 Pandemic on Treatment Delays in Patients with ST-Segment Elevation Myocardial Infarction
title_sort effect of the covid-19 pandemic on treatment delays in patients with st-segment elevation myocardial infarction
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7408681/
https://www.ncbi.nlm.nih.gov/pubmed/32664309
http://dx.doi.org/10.3390/jcm9072183
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