Cargando…
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...
Autores principales: | , , , , , , , , , , , , , , , |
---|---|
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 |
_version_ | 1783567887739387904 |
---|---|
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. |
format | Online Article Text |
id | pubmed-7408681 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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 |
work_keys_str_mv | AT reinstadlersebastianj effectofthecovid19pandemicontreatmentdelaysinpatientswithstsegmentelevationmyocardialinfarction AT reindlmartin effectofthecovid19pandemicontreatmentdelaysinpatientswithstsegmentelevationmyocardialinfarction AT lechnerivan effectofthecovid19pandemicontreatmentdelaysinpatientswithstsegmentelevationmyocardialinfarction AT holzknechtmagdalena effectofthecovid19pandemicontreatmentdelaysinpatientswithstsegmentelevationmyocardialinfarction AT tillerchristina effectofthecovid19pandemicontreatmentdelaysinpatientswithstsegmentelevationmyocardialinfarction AT roithingerfranzxaver effectofthecovid19pandemicontreatmentdelaysinpatientswithstsegmentelevationmyocardialinfarction AT frickmatthias effectofthecovid19pandemicontreatmentdelaysinpatientswithstsegmentelevationmyocardialinfarction AT hoppeutac effectofthecovid19pandemicontreatmentdelaysinpatientswithstsegmentelevationmyocardialinfarction AT jirakpeter effectofthecovid19pandemicontreatmentdelaysinpatientswithstsegmentelevationmyocardialinfarction AT bergerrudolf effectofthecovid19pandemicontreatmentdelaysinpatientswithstsegmentelevationmyocardialinfarction AT dellekarthgeorg effectofthecovid19pandemicontreatmentdelaysinpatientswithstsegmentelevationmyocardialinfarction AT laßnigelisabeth effectofthecovid19pandemicontreatmentdelaysinpatientswithstsegmentelevationmyocardialinfarction AT kluggert effectofthecovid19pandemicontreatmentdelaysinpatientswithstsegmentelevationmyocardialinfarction AT baueraxel effectofthecovid19pandemicontreatmentdelaysinpatientswithstsegmentelevationmyocardialinfarction AT binderronald effectofthecovid19pandemicontreatmentdelaysinpatientswithstsegmentelevationmyocardialinfarction AT metzlerbernhard effectofthecovid19pandemicontreatmentdelaysinpatientswithstsegmentelevationmyocardialinfarction |