Recovery From the Impact of COVID-19 on Treatment Times and Clinical Outcomes of Patients With ST-Segment Elevation Myocardial Infarction : An Interim Analysis
© 2023 by the Texas Heart® Institute, Houston..
BACKGROUND: Previous studies have documented a negative impact of the COVID-19 pandemic on emergent percutaneous treatment of patients with ST-segment elevation myocardial infarction (STEMI), but few have examined recovery of healthcare systems in restoring prepandemic STEMI care.
METHODS: Retrospective analysis was performed of data from 789 patients with STEMI from a large tertiary medical center treated with percutaneous coronary intervention between January 1, 2019, and December 31, 2021.
RESULTS: For patients with STEMI presenting to the emergency department, median time from door to balloon was 37 minutes in 2019, 53 minutes in 2020, and 48 minutes in 2021 (P < .001), whereas median time from first medical contact to device changed from 70 to 82 to 75 minutes, respectively (P = .002). Treatment time changes in 2020 and 2021 correlated with median emergency department evaluation time (30 to 41 to 22 minutes, respectively; P = .001) but not median catheterization laboratory revascularization time. For transfer patients, median time from first medical contact to device changed from 110 to 133 to 118 minutes, respectively (P = .005). In 2020 and 2021, patients with STEMI had greater late presentation (P = .028) and late mechanical complications (P = .021), with nonsignificant increases in yearly in-hospital mortality (3.6% to 5.2% to 6.4%; P = .352).
CONCLUSION: COVID-19 was associated with worsening STEMI treatment times and outcomes in 2020. Despite improving treatment times in 2021, in-hospital mortality had not decreased in the setting of a persistent increase in late patient presentation and associated STEMI complications.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:50 |
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| Enthalten in: |
Texas Heart Institute journal - 50(2023), 2 vom: 01. März |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Ali, Abdelrahman [VerfasserIn] |
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| Links: |
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| Themen: |
COVID-19 |
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| Anmerkungen: |
Date Completed 15.03.2023 Date Revised 15.05.2023 published: Print Citation Status MEDLINE |
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| doi: |
10.14503/THIJ-22-7919 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM354188771 |
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| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023 by the Texas Heart® Institute, Houston. | ||
| 520 | |a BACKGROUND: Previous studies have documented a negative impact of the COVID-19 pandemic on emergent percutaneous treatment of patients with ST-segment elevation myocardial infarction (STEMI), but few have examined recovery of healthcare systems in restoring prepandemic STEMI care | ||
| 520 | |a METHODS: Retrospective analysis was performed of data from 789 patients with STEMI from a large tertiary medical center treated with percutaneous coronary intervention between January 1, 2019, and December 31, 2021 | ||
| 520 | |a RESULTS: For patients with STEMI presenting to the emergency department, median time from door to balloon was 37 minutes in 2019, 53 minutes in 2020, and 48 minutes in 2021 (P < .001), whereas median time from first medical contact to device changed from 70 to 82 to 75 minutes, respectively (P = .002). Treatment time changes in 2020 and 2021 correlated with median emergency department evaluation time (30 to 41 to 22 minutes, respectively; P = .001) but not median catheterization laboratory revascularization time. For transfer patients, median time from first medical contact to device changed from 110 to 133 to 118 minutes, respectively (P = .005). In 2020 and 2021, patients with STEMI had greater late presentation (P = .028) and late mechanical complications (P = .021), with nonsignificant increases in yearly in-hospital mortality (3.6% to 5.2% to 6.4%; P = .352) | ||
| 520 | |a CONCLUSION: COVID-19 was associated with worsening STEMI treatment times and outcomes in 2020. Despite improving treatment times in 2021, in-hospital mortality had not decreased in the setting of a persistent increase in late patient presentation and associated STEMI complications | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a COVID-19 | |
| 650 | 4 | |a STEMI | |
| 650 | 4 | |a percutaneous coronary intervention | |
| 700 | 1 | |a Schirmer, Thomas |e verfasserin |4 aut | |
| 700 | 1 | |a Kiernan, Francis J |e verfasserin |4 aut | |
| 700 | 1 | |a Piccirillo, Bryan |e verfasserin |4 aut | |
| 700 | 1 | |a Ingrassia, Joseph |e verfasserin |4 aut | |
| 700 | 1 | |a Azemi, Talhat |e verfasserin |4 aut | |
| 700 | 1 | |a Sadiq, Immad |e verfasserin |4 aut | |
| 700 | 1 | |a Fram, Daniel B |e verfasserin |4 aut | |
| 700 | 1 | |a Rizvi, Asad |e verfasserin |4 aut | |
| 700 | 1 | |a Joshi, Saurabh |e verfasserin |4 aut | |
| 700 | 1 | |a Mather, Jeffrey |e verfasserin |4 aut | |
| 700 | 1 | |a McKay, Raymond G |e verfasserin |4 aut | |
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