Effect of the COVID-19 pandemic on access to primary percutaneous coronary intervention for ST-segment elevation
Göksel Çinier1, Mert Hayıroğlu1, Levent Pay1
1Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.
Insights
The COVID-19 pandemic significantly reduced ST-segment myocardial infarction (STEMI) cases and prolonged treatment times for those affected. Patients experienced longer pain-to-balloon and door-to-balloon times, indicating delays in primary percutaneous coronary intervention (PPCI) access.
Area of Science:
- Cardiology
- Public Health
- Emergency Medicine
Background:
- The COVID-19 pandemic has caused a global health crisis, impacting healthcare access.
- The effect on acute conditions like ST-segment myocardial infarction (STEMI) is under investigation.
- Primary percutaneous coronary intervention (PPCI) is a critical treatment for STEMI.
Purpose of the Study:
- To investigate access to PPCI for STEMI patients during the COVID-19 pandemic.
- To compare treatment delays during the pandemic versus pre-pandemic periods.
Main Methods:
- Retrospective analysis of STEMI patients undergoing PPCI.
- Comparison between pandemic period and a control group from the prior year.
- Assessment of clinical, angiographic characteristics, and treatment times (pain-to-balloon, door-to-balloon).
Main Results:
- A significant reduction in STEMI cases during the COVID-19 crisis.
- STEMI patients during the pandemic had prolonged ischemic times.
- Increased odds of longer pain-to-balloon (OR: 2.0) and door-to-balloon (OR: 5.4) times during the pandemic.
Conclusions:
- STEMI patients during the COVID-19 pandemic faced significant delays in receiving PPCI.
- The pandemic negatively impacted timely access to critical cardiac interventions.
Objective:
The coronavirus disease 2019 (COVID-19) pandemic caused by the emergence of severe acute respiratory syndrome coronavirus 2 has resulted in a health crisis and a significant number of deaths worldwide. The full effect on access to medical care and the treatment for patients with chronic diseases and acute conditions is still unknown. This is an investigation of access to primary percutaneous coronary intervention (PPCI) for patients diagnosed with ST-segment myocardial infarction (STEMI) during the pandemic.
Methods:
Consecutive patients who were diagnosed with STEMI and underwent PPCI during the ongoing COVID-19 pandemic were included in the study. Clinical and angiographic characteristics of the patients were assessed. A control group of patients diagnosed with STEMI and who underwent PPCI during the same time interval a year prior to the outbreak of the disease was analyzed retrospectively for comparison.
Results:
There was a significant reduction in the number of STEMI cases during the COVID-19 crisis period. Furthermore, these patients had a prolonged ischemic time; they were more likely to have a longer pain-to-balloon (Odds ratio [OR]: 2.0, 95% confidence interval [CI]: 1.1-10.2) and door-to-balloon time (OR: 5.4, 95% CI: 3.1-22.8).
Conclusion:
Patients diagnosed with STEMI during the pandemic experienced a significant delay between the onset of symptoms and PPCI.
More Related Videos
18:11A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
Published on: December 28, 2012
05:26Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction
Published on: May 28, 2019
Related Concept Videos
01:30Acute Coronary Syndrome I: Introduction
01:28Acute Coronary Syndrome IV: Interprofessional Care
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
01:27Coronary Artery Disease V: Interprofessional Care
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:27Peripheral Artery Disease III: Interprofessional Care