Impact of COVID-19 pandemic on STEMI undergoing primary PCI treatment in Beijing, China.

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: https://ClinicalTrials.gov Unique identifier: NCT04427735.

• Authors: Xuhe Gong, Li Zhou, Tianhui Dong, Xiaosong Ding, Huiqiang Zhao, Hui Chen, Hongwei Li
• Journal: The American journal of emergency medicine (Am J Emerg Med) Vol. 53 Pg. 68-72 (03 2022) ISSN: 1532-8171 [Electronic] United States
• PMID: 34999563 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2021. Published by Elsevier Inc.

Topics

• Aged
• Beijing (epidemiology)
• COVID-19 (complications, prevention & control, transmission)
• Cohort Studies
• Female
• Humans
• Male
• Middle Aged
• Percutaneous Coronary Intervention (statistics & numerical data, trends)
• Retrospective Studies
• ST Elevation Myocardial Infarction (epidemiology, therapy)
• Time Factors
• Time-to-Treatment (standards, statistics & numerical data)
• Treatment Outcome