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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis

Published on: December 28, 2012

Incidence, delays, and outcomes of STEMI during COVID-19 outbreak: Analysis from the France PCI registry

Grégoire Rangé1, Radwan Hakim1, Farzin Beygui2

  • 1Cardiology department Les hôpitaux de Chartres Chartres France.

Journal of the American College of Emergency Physicians Open
|December 28, 2020
PubMed

Insights

The COVID-19 outbreak in France led to a 12% decrease in ST-elevation myocardial infarction (STEMI) patients receiving primary percutaneous coronary intervention (PPCI). Delays in emergency care increased, and while mortality rates doubled, the difference was not statistically significant.

Area of Science:

  • Cardiology
  • Public Health
  • Epidemiology

Background:

  • The coronavirus disease 2019 (COVID-19) pandemic has significantly impacted healthcare systems globally.
  • Understanding its effect on acute cardiovascular events, such as ST-elevation myocardial infarction (STEMI), is crucial for patient outcomes.

Purpose of the Study:

  • To evaluate the influence of the COVID-19 outbreak on the incidence, care delays, and outcomes of STEMI patients undergoing primary percutaneous coronary intervention (PPCI) in France.
  • To compare pre-lockdown and lockdown periods regarding patient numbers, treatment delays, and in-hospital major adverse cardiac events (MACE).

Main Methods:

  • Analysis of STEMI patients undergoing PPCI within 24 hours, registered in the prospective France PCI registry.
  • Comparison of mean monthly patient numbers, care pathway delays, and in-hospital MACE between pre-lockdown and lockdown groups.
  • Statistical analysis to determine the significance of observed differences.

Main Results:

  • A total of 2064 STEMI patients were included (1942 pre-lockdown, 122 lockdown).
  • A significant 12% decrease in mean monthly STEMI patients undergoing PPCI was observed during the lockdown period (p < 0.04).
  • A significant increase in "symptom onset to first medical contact" delay was noted for direct-to-emergency department patients (238 vs. 450 minutes; p = 0.04).
  • Higher rates of in-hospital MACE (7.7% vs. 12.3%) and mortality (4.9% vs. 8.2%) were observed during lockdown, though not statistically significant.

Conclusions:

  • The COVID-19 outbreak in France was associated with a significant reduction in STEMI patients undergoing PPCI.
  • Increased transfer times were observed for patients presenting directly to emergency departments.
  • Although mortality rates doubled during the lockdown, the increase was not statistically significant, warranting further investigation.
Abstract

Keywords:
Acute coronary syndromCOVID‐19Myocardial infarctionPercutaneous coronary interventionSTEMI

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