Effect of Covid-19 pandemic process on STEMI patients timeline
Korhan Soylu1, Metin Coksevim1, Ahmet Yanık2
1Department of Cardiology, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey.
Insights
During the COVID-19 pandemic, ST-segment elevation myocardial infarction (STEMI) patients experienced significantly longer prehospital delays. This highlights the need for strategies to mitigate treatment delays during health crises.
Area of Science:
- Cardiology
- Public Health
- Emergency Medicine
Background:
- Delayed revascularization in ST-segment elevation myocardial infarction (STEMI) is linked to adverse patient outcomes.
- The COVID-19 pandemic presented unprecedented challenges to healthcare systems globally.
- Understanding the impact of the pandemic on acute cardiovascular care timelines is crucial.
Purpose of the Study:
- To evaluate how the COVID-19 pandemic affected the timeliness of STEMI treatment.
- To compare prehospital and in-hospital delays in STEMI care during the pandemic versus a pre-pandemic period.
Main Methods:
- A comparative study involving 165 STEMI patients, divided into pandemic and control (pre-pandemic) groups.
- Data collection included home delay, first medical contact (FMC) delay, door-to-balloon time, procedure time, and hospitalization duration.
- Statistical analysis was performed to compare timelines between the two periods.
Main Results:
- STEMI patients during the pandemic showed significantly prolonged home delay and FMC delay compared to the control group.
- The rate of non-infarct-related artery percutaneous coronary intervention (PCI) decreased during the pandemic.
- Hospitalization time was also reduced during the pandemic period.
Conclusions:
- The COVID-19 pandemic was associated with significant delays in prehospital STEMI treatment.
- Healthcare systems must implement proactive measures to prevent unfavorable delays in STEMI care during public health emergencies.
- Further research is needed to optimize STEMI treatment pathways during crises.
Objective:
Delayed revascularisation in patients with ST-segment elevation myocardial infarction (STEMI) is associated with poor prognosis. The aim of this study is to investigate how the timeline in STEMI treatment was affected during the Covid-19 outbreak.
Method:
Consecutive 165 STEMI patients were enrolled in the study during the Covid-19 pandemic period (Pandemic period) and the prepandemic period (Control period). The time period until patients' leaving their current position after the onset of pain (home delay), the time from the onset of pain to the first medical contact (FMC delay), door-to-balloon time, procedure time and hospitalisation time were recorded.
Results:
A total of 165 patients, 82 in the Pandemic period and 83 in the Control period, were included in the study. When compared with the control period, home delay [30 (5-6912) minutes vs 165 (10-360) minutes, P < .001] and FMC delay [61 (20-6932) minutes vs 190 (15-3660) minutes, P < .001] were significantly prolonged during the pandemic period. In addition, non-IRA PCI rate (8.8% vs 19.3% P = .043) and hospitalisation time [71 (15-170) vs 74.2 (37-329) hours, P = .045] were decreased.
Conclusion:
During the Covid-19 pandemic period, prolonged prehospital time parameters were observed in STEMI patients. Therefore, additional measures may be required to prevent unfavourable delays in STEMI patients during the outbreak.
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