COVID-19 pandemic, mechanical reperfusion and 30-day mortality in ST elevation myocardial infarction

G. De Luca; M. Algowhary; B. Uguz; D.C. Oliveira; V. Ganyukov; Z. Zimbakov; M. Cercek; L.O. Jensen; P.H. Loh; L. Calmac; G. Roura-Ferrer; A. Quadros; M. Milewski; F.S. di Uccio; C. von Birgelen; F. Versaci; J. Ten Berg; G. Casella; A.S.L. Wong; P. Kala; J.L.D. Gil; X. Carrillo; M.T. Dirksen; V.M. Becerra-Munoz; M.K.Y. Lee; D.A. Juzar; R.D. Joaquim; R. Paladino; D. Milicic; P. Davlouros; N. Bakraceski; F. Zilio; L. Donazzan; A.O. Kraaijeveld; G. Galasso; A. Lux; L. Marinucci; V. Guiducci; M. Menichelli; A. Scoccia; A. Yamac; K.U. Mert; X.F. Rios; T. Kovarnik; M. Kidawa; J. Moreu; V. Flavien; E. Fabris; I.L. Martinez-Luengas; M. Boccalatte

doi:10.1136/heartjnl-2021-319750

COVID-19 pandemic, mechanical reperfusion and 30-day mortality in ST elevation myocardial infarction

G. De Luca^*, M. Algowhary, B. Uguz, D.C. Oliveira, V. Ganyukov, Z. Zimbakov, M. Cercek, L.O. Jensen, P.H. Loh, L. Calmac, G. Roura-Ferrer, A. Quadros, M. Milewski, F.S. di Uccio, C. von Birgelen, F. Versaci, J. Ten Berg, G. Casella, A.S.L. Wong, P. KalaJ.L.D. Gil, X. Carrillo, M.T. Dirksen, V.M. Becerra-Munoz, M.K.Y. Lee, D.A. Juzar, R.D. Joaquim, R. Paladino, D. Milicic, P. Davlouros, N. Bakraceski, F. Zilio, L. Donazzan, A.O. Kraaijeveld, G. Galasso, A. Lux, L. Marinucci, V. Guiducci, M. Menichelli, A. Scoccia, A. Yamac, K.U. Mert, X.F. Rios, T. Kovarnik, M. Kidawa, J. Moreu, V. Flavien, E. Fabris, I.L. Martinez-Luengas, M. Boccalatte

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Objective The initial data of the International Study on Acute Coronary Syndromes - ST Elevation Myocardial Infarction COVID-19 showed in Europe a remarkable reduction in primary percutaneous coronary intervention procedures and higher in-hospital mortality during the initial phase of the pandemic as compared with the prepandemic period. The aim of the current study was to provide the final results of the registry, subsequently extended outside Europe with a larger inclusion period (up to June 2020) and longer follow-up (up to 30 days).Methods This is a retrospective multicentre registry in 109 high-volume primary percutaneous coronary intervention (PPCI) centres from Europe, Latin America, South-East Asia and North Africa, enrolling 16 674 patients with ST segment elevation myocardial infarction (STEMI) undergoing PPPCI in March/June 2019 and 2020. The main study outcomes were the incidence of PPCI, delayed treatment (ischaemia time >12 hours and door-to-balloon >30 min), in-hospital and 30-day mortality.Results In 2020, during the pandemic there was a significant reduction in PPCI as compared with 2019 (incidence rate ratio 0.843, 95% CI 0.825 to 0.861, p<0.0001). This reduction was significantly associated with age, being higher in older adults (>75 years) (p=0.015), and was not related to the peak of cases or deaths due to COVID-19. The heterogeneity among centres was high (p<0.001). Furthermore, the pandemic was associated with a significant increase in doorto-balloon time (40 (25-70) min vs 40 (25-64) min, p=0.01) and total ischaemia time (225 (135-410) min vs 196 (120-355) min, p<0.001), which may have contributed to the higher in-hospital (6.5% vs 5.3%, p<0.001) and 30-day (8% vs 6.5%, p=0.001) mortality observed during the pandemic.Conclusion Percutaneous revascularisation for STEMI was significantly affected by the COVID-19 pandemic, with a 16% reduction in PPCI procedures, especially among older patients (about 20%), and longer delays to treatment, which may have contributed to the increased in-hospital and 30-day mortality during the pandemic.

Original language	English
Pages (from-to)	458-466
Number of pages	9
Journal	Heart
Volume	108
Issue number	6
Early online date	27 Oct 2021
DOIs	https://doi.org/10.1136/heartjnl-2021-319750
Publication status	Published - Mar 2022

Access to Document

10.1136/heartjnl-2021-319750Licence: Unspecified

Cite this

De Luca, G., Algowhary, M., Uguz, B., Oliveira, D. C., Ganyukov, V., Zimbakov, Z., Cercek, M., Jensen, L. O., Loh, P. H., Calmac, L., Roura-Ferrer, G., Quadros, A., Milewski, M., di Uccio, F. S., von Birgelen, C., Versaci, F., Ten Berg, J., Casella, G., Wong, A. S. L., ... Boccalatte, M. (2022). COVID-19 pandemic, mechanical reperfusion and 30-day mortality in ST elevation myocardial infarction. Heart, 108(6), 458-466. https://doi.org/10.1136/heartjnl-2021-319750

@article{9cf432197b344acd8ce87fef3c2d21f7,

title = "COVID-19 pandemic, mechanical reperfusion and 30-day mortality in ST elevation myocardial infarction",

abstract = "Objective The initial data of the International Study on Acute Coronary Syndromes - ST Elevation Myocardial Infarction COVID-19 showed in Europe a remarkable reduction in primary percutaneous coronary intervention procedures and higher in-hospital mortality during the initial phase of the pandemic as compared with the prepandemic period. The aim of the current study was to provide the final results of the registry, subsequently extended outside Europe with a larger inclusion period (up to June 2020) and longer follow-up (up to 30 days).Methods This is a retrospective multicentre registry in 109 high-volume primary percutaneous coronary intervention (PPCI) centres from Europe, Latin America, South-East Asia and North Africa, enrolling 16 674 patients with ST segment elevation myocardial infarction (STEMI) undergoing PPPCI in March/June 2019 and 2020. The main study outcomes were the incidence of PPCI, delayed treatment (ischaemia time >12 hours and door-to-balloon >30 min), in-hospital and 30-day mortality.Results In 2020, during the pandemic there was a significant reduction in PPCI as compared with 2019 (incidence rate ratio 0.843, 95% CI 0.825 to 0.861, p<0.0001). This reduction was significantly associated with age, being higher in older adults (>75 years) (p=0.015), and was not related to the peak of cases or deaths due to COVID-19. The heterogeneity among centres was high (p<0.001). Furthermore, the pandemic was associated with a significant increase in doorto-balloon time (40 (25-70) min vs 40 (25-64) min, p=0.01) and total ischaemia time (225 (135-410) min vs 196 (120-355) min, p<0.001), which may have contributed to the higher in-hospital (6.5% vs 5.3%, p<0.001) and 30-day (8% vs 6.5%, p=0.001) mortality observed during the pandemic.Conclusion Percutaneous revascularisation for STEMI was significantly affected by the COVID-19 pandemic, with a 16% reduction in PPCI procedures, especially among older patients (about 20%), and longer delays to treatment, which may have contributed to the increased in-hospital and 30-day mortality during the pandemic.",

author = "{De Luca}, G. and M. Algowhary and B. Uguz and D.C. Oliveira and V. Ganyukov and Z. Zimbakov and M. Cercek and L.O. Jensen and P.H. Loh and L. Calmac and G. Roura-Ferrer and A. Quadros and M. Milewski and {di Uccio}, F.S. and {von Birgelen}, C. and F. Versaci and {Ten Berg}, J. and G. Casella and A.S.L. Wong and P. Kala and J.L.D. Gil and X. Carrillo and M.T. Dirksen and V.M. Becerra-Munoz and M.K.Y. Lee and D.A. Juzar and R.D. Joaquim and R. Paladino and D. Milicic and P. Davlouros and N. Bakraceski and F. Zilio and L. Donazzan and A.O. Kraaijeveld and G. Galasso and A. Lux and L. Marinucci and V. Guiducci and M. Menichelli and A. Scoccia and A. Yamac and K.U. Mert and X.F. Rios and T. Kovarnik and M. Kidawa and J. Moreu and V. Flavien and E. Fabris and I.L. Martinez-Luengas and M. Boccalatte",

note = "Publisher Copyright: {\textcopyright} Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.",

year = "2022",

month = mar,

doi = "10.1136/heartjnl-2021-319750",

language = "English",

volume = "108",

pages = "458--466",

journal = "Heart",

issn = "1355-6037",

publisher = "BMJ Publishing Group",

number = "6",

}

De Luca, G, Algowhary, M, Uguz, B, Oliveira, DC, Ganyukov, V, Zimbakov, Z, Cercek, M, Jensen, LO, Loh, PH, Calmac, L, Roura-Ferrer, G, Quadros, A, Milewski, M, di Uccio, FS, von Birgelen, C, Versaci, F, Ten Berg, J, Casella, G, Wong, ASL, Kala, P, Gil, JLD, Carrillo, X, Dirksen, MT, Becerra-Munoz, VM, Lee, MKY, Juzar, DA, Joaquim, RD, Paladino, R, Milicic, D, Davlouros, P, Bakraceski, N, Zilio, F, Donazzan, L, Kraaijeveld, AO, Galasso, G, Lux, A, Marinucci, L, Guiducci, V, Menichelli, M, Scoccia, A, Yamac, A, Mert, KU, Rios, XF, Kovarnik, T, Kidawa, M, Moreu, J, Flavien, V, Fabris, E, Martinez-Luengas, IL & Boccalatte, M 2022, 'COVID-19 pandemic, mechanical reperfusion and 30-day mortality in ST elevation myocardial infarction', Heart, vol. 108, no. 6, pp. 458-466. https://doi.org/10.1136/heartjnl-2021-319750

TY - JOUR

T1 - COVID-19 pandemic, mechanical reperfusion and 30-day mortality in ST elevation myocardial infarction

AU - De Luca, G.

AU - Algowhary, M.

AU - Uguz, B.

AU - Oliveira, D.C.

AU - Ganyukov, V.

AU - Zimbakov, Z.

AU - Cercek, M.

AU - Jensen, L.O.

AU - Loh, P.H.

AU - Calmac, L.

AU - Roura-Ferrer, G.

AU - Quadros, A.

AU - Milewski, M.

AU - di Uccio, F.S.

AU - von Birgelen, C.

AU - Versaci, F.

AU - Ten Berg, J.

AU - Casella, G.

AU - Wong, A.S.L.

AU - Kala, P.

AU - Gil, J.L.D.

AU - Carrillo, X.

AU - Dirksen, M.T.

AU - Becerra-Munoz, V.M.

AU - Lee, M.K.Y.

AU - Juzar, D.A.

AU - Joaquim, R.D.

AU - Paladino, R.

AU - Milicic, D.

AU - Davlouros, P.

AU - Bakraceski, N.

AU - Zilio, F.

AU - Donazzan, L.

AU - Kraaijeveld, A.O.

AU - Galasso, G.

AU - Lux, A.

AU - Marinucci, L.

AU - Guiducci, V.

AU - Menichelli, M.

AU - Scoccia, A.

AU - Yamac, A.

AU - Mert, K.U.

AU - Rios, X.F.

AU - Kovarnik, T.

AU - Kidawa, M.

AU - Moreu, J.

AU - Flavien, V.

AU - Fabris, E.

AU - Martinez-Luengas, I.L.

AU - Boccalatte, M.

PY - 2022/3

Y1 - 2022/3

N2 - Objective The initial data of the International Study on Acute Coronary Syndromes - ST Elevation Myocardial Infarction COVID-19 showed in Europe a remarkable reduction in primary percutaneous coronary intervention procedures and higher in-hospital mortality during the initial phase of the pandemic as compared with the prepandemic period. The aim of the current study was to provide the final results of the registry, subsequently extended outside Europe with a larger inclusion period (up to June 2020) and longer follow-up (up to 30 days).Methods This is a retrospective multicentre registry in 109 high-volume primary percutaneous coronary intervention (PPCI) centres from Europe, Latin America, South-East Asia and North Africa, enrolling 16 674 patients with ST segment elevation myocardial infarction (STEMI) undergoing PPPCI in March/June 2019 and 2020. The main study outcomes were the incidence of PPCI, delayed treatment (ischaemia time >12 hours and door-to-balloon >30 min), in-hospital and 30-day mortality.Results In 2020, during the pandemic there was a significant reduction in PPCI as compared with 2019 (incidence rate ratio 0.843, 95% CI 0.825 to 0.861, p<0.0001). This reduction was significantly associated with age, being higher in older adults (>75 years) (p=0.015), and was not related to the peak of cases or deaths due to COVID-19. The heterogeneity among centres was high (p<0.001). Furthermore, the pandemic was associated with a significant increase in doorto-balloon time (40 (25-70) min vs 40 (25-64) min, p=0.01) and total ischaemia time (225 (135-410) min vs 196 (120-355) min, p<0.001), which may have contributed to the higher in-hospital (6.5% vs 5.3%, p<0.001) and 30-day (8% vs 6.5%, p=0.001) mortality observed during the pandemic.Conclusion Percutaneous revascularisation for STEMI was significantly affected by the COVID-19 pandemic, with a 16% reduction in PPCI procedures, especially among older patients (about 20%), and longer delays to treatment, which may have contributed to the increased in-hospital and 30-day mortality during the pandemic.

AB - Objective The initial data of the International Study on Acute Coronary Syndromes - ST Elevation Myocardial Infarction COVID-19 showed in Europe a remarkable reduction in primary percutaneous coronary intervention procedures and higher in-hospital mortality during the initial phase of the pandemic as compared with the prepandemic period. The aim of the current study was to provide the final results of the registry, subsequently extended outside Europe with a larger inclusion period (up to June 2020) and longer follow-up (up to 30 days).Methods This is a retrospective multicentre registry in 109 high-volume primary percutaneous coronary intervention (PPCI) centres from Europe, Latin America, South-East Asia and North Africa, enrolling 16 674 patients with ST segment elevation myocardial infarction (STEMI) undergoing PPPCI in March/June 2019 and 2020. The main study outcomes were the incidence of PPCI, delayed treatment (ischaemia time >12 hours and door-to-balloon >30 min), in-hospital and 30-day mortality.Results In 2020, during the pandemic there was a significant reduction in PPCI as compared with 2019 (incidence rate ratio 0.843, 95% CI 0.825 to 0.861, p<0.0001). This reduction was significantly associated with age, being higher in older adults (>75 years) (p=0.015), and was not related to the peak of cases or deaths due to COVID-19. The heterogeneity among centres was high (p<0.001). Furthermore, the pandemic was associated with a significant increase in doorto-balloon time (40 (25-70) min vs 40 (25-64) min, p=0.01) and total ischaemia time (225 (135-410) min vs 196 (120-355) min, p<0.001), which may have contributed to the higher in-hospital (6.5% vs 5.3%, p<0.001) and 30-day (8% vs 6.5%, p=0.001) mortality observed during the pandemic.Conclusion Percutaneous revascularisation for STEMI was significantly affected by the COVID-19 pandemic, with a 16% reduction in PPCI procedures, especially among older patients (about 20%), and longer delays to treatment, which may have contributed to the increased in-hospital and 30-day mortality during the pandemic.

U2 - 10.1136/heartjnl-2021-319750

DO - 10.1136/heartjnl-2021-319750

M3 - Article

C2 - 34711661

SN - 1355-6037

VL - 108

SP - 458

EP - 466

JO - Heart

JF - Heart

IS - 6

ER -